基于PI-RADS v2.1评价双参数成像对前列腺癌的诊断价值

Evaluation of the Diagnostic Value of Biparametric MRI in Prostate Cancer Based on PI-RADS v2.1

目的基于前列腺影像报告和数据系统第2.1版(PI-RADS v2.1),探讨双参数磁共振(Bp-MRI)对前列腺癌(PCa)的诊断价值。方法回顾性搜集PCa疑诊患者279例,由两名医师分别采用不同MRI方案(T_(2)WI、DWI、DCE-MRI、T_(2)WI-DCE、Bp-MRI及Mp-MRI)按照PI-RADS v2.1评分标准对图像进行评分。评估两名医师评分一致性强度,绘制ROC曲线并计算曲线下面积(AUC)评估不同评分方案诊断PCa的效能,并比较各方案AUC间的差异。结果两名医师同一方案的PI-RADS评分具有良好的一致性(P值均<0.05);不同评分方案诊断PCa的AUC分别为0.87(T_(2)WI)、0.84(DWI)、0.66(DCE-MRI)、0.85(T_(2)WI-DCE)、0.89(Bp-MRI)、0.90(Mp-MRI),其中,Bp-MRI与DWI、DCE-MRI、T_(2)WI-DCE的AUC差异具有统计学意义(P值均<0.05),Bp-MRI与T_(2)WI、Mp-MRI的AUC差异无统计学意义(P值均>0.05)。Bp-MRI诊断PCa的敏感性、特异性、阳性预测值、阴性预测值分别为0.86、0.87、0.89、0.84,与Mp-MRI在PCa的诊断效能上有相似的精度(Mp-MRI:0.87、0.86、0.88、0.84)。结论基于PI-RADS v2.1的Bp-MRI对PCa有较好的诊断效能,一定条件下将Bp-MRI代替Mp-MRI来诊断PCa是可行的。

Objective To explore the diagnostic value of biparametric magnetic resonance imaging(BP-MRI)for prostate cancer(PCa)based on prostate imaging reporting and data system version 2.1(PI-RADS v2.1).Methods Totally 279 with suspected PCa were retrospectively enrolled andthe imaging features were scored by two physicians with different MRI protocols.Scoring criteria were strictly according to PI-RADSv2.1.Consistency of the scores between two physicians was evaluated,and the ROC curve was used to explore the diagnostic efficacy of Bp-MRI in PCa.Results The scores of the two physicians use the same protocols showed a good consistency(P<0.05).The AUC of PCa in each group was 0.87(T_(2)WI),0.84(DWI),0.66(DCE-MRI),0.85(T_(2)WI-DCE),0.89(BP-MRI)and 0.90(MP-MRI),respectively.There were statistically significant differences between Bp-MRI with DWI,DCE-MRI and T_(2)WI-DCE in AUC(P<0.05),while there were no statistically significant differences between BP-MRI with T_(2)WI and MP-MRI in AUC(P>0.05).The sensitivity,specificity,positive predictive value and negative predictive value of PCa in the diagnosis of BP-MRI were 0.86,0.87,0.89 and 0.84 respectively,which shows a similar accuracy with MP-MRI in the diagnostic efficacy of PCa(MPMRI:0.87,0.86,0.88 and 0.84).Conclusion BP-MRI based on PI-RADS v2.1 has a good ability in PCa diagnosis,and it is feasible to use BP-MRI as a PCa diagnosis scheme under some certain conditions.