Background:Vesical Imaging-Reporting and Data System(Ⅵ-RADS)was developed as a structured reporting tool to anticipate the possibility of muscle invasion.This study is aimed to investigate the diagnostic accuracy of...Background:Vesical Imaging-Reporting and Data System(Ⅵ-RADS)was developed as a structured reporting tool to anticipate the possibility of muscle invasion.This study is aimed to investigate the diagnostic accuracy ofⅥ-RADS for discriminating T2 from T1 bladder cancer.Materials and methods:Scopus,Web of Science,PubMed,and Embase were searched on October 4,2021,for studies with the following characteristics:(1)bladder cancer patient population,(2)Ⅵ-RADS as an index test,(3)retransurethral resection of bladder tumor/cystectomy as a reference,and(4)adequateⅥ-RADS score data for T1 and T2 lesions.The analyses were performed using the binary regression model of MIDAS in Stata.Results:Six studies with 624 magnetic resonance imaging reports were included.The receiver operating characteristics curve for differentiation of T2 from T1 bladder cancer showed an area under the curve of 0.93(95%confidence interval[CI],0.91-0.95)for aⅥ-RADS≥3 and 0.75(95%CI,0.71-0.79)for aⅥ-RADS≥4.AⅥ-RADS≥3 showed high sensitivity of 93%(95%CI,85%-97%),specificity of 61%(95%CI,30%-86%),positive likelihood ratio of 2.4(95%CI,1.1-5.3),and negative likelihood ratio of 0.11(95%CI,0.05-0.24).A total of 10.4%of T2 lesions were scored asⅥ-RADS 2,while 10%of T1 lesions were scored asⅥ-RADS 4 or 5.Conclusions:TheⅥ-RADS≥3 has high accuracy and sensitivity for detecting muscle invasion in borderline populations of T1 or T2 bladder cancer.Thus,theⅥ-RADS could be a good non-invasive screening test for the detection of T2 urothelial lesions.展开更多
Objective:Vesical Imaging Reporting and Data System(VIRADS)score was developed to standardize the reporting and staging of bladder tumors on pre-operative multiparametric magnetic resonance imaging.It helps in avoidin...Objective:Vesical Imaging Reporting and Data System(VIRADS)score was developed to standardize the reporting and staging of bladder tumors on pre-operative multiparametric magnetic resonance imaging.It helps in avoiding unnecessary repeat transurethral resection of bladder tumor in high-risk non-muscle-invasive bladder cancer patients.This study was done to determine the validity of VIRADS score prospectively for the diagnosis of muscleinvasive bladder cancer.Methods:This study was conducted from March 2019 to March 2020 at Sawai Man Singh Medical College and Hospital,Jaipur,Rajasthan,India.Patients admitted with the provisional diagnosis of bladder tumor were included as participants.All these patients underwent a 3 Tesla mpMRI to obtain a VIRADS score before they underwent transurethral resection of bladder tumor and these data were analyzed to evaluate the correlation of pre-operative VIRADS score with mus-cle invasiveness of the tumor in final biopsy report.Results:A cut-off of VIRADS≥4 for prediction of detrusor muscle invasion yielded a sensitivity of 79.4%,specificity of 94.2%,positive predictive value of 90.0%,negative predictive value of 87.5%,and diagnostic accuracy of 86.4%.A cut off of VIRADS≥3 for prediction of detrusor muscle invasion yielded a sensitivity of 91.2%,specificity of 78.8%,positive predictive value of 73.8%,negative predictive value of 93.2%,and accuracy of 83.7%.The receiver operating curve showed the area under the curve to be 0.922(95%confidence interval:0.862e0.983).Conclusion:VIRADS score appears to be an excellent and effective pre-operative radiological tool for the prediction of detrusor muscle invasion in bladder cancer.展开更多
目的本研究旨在探讨多参数MRI膀胱影像报告与数据系统(vesical imaging reporting and data system,VI-RADS)预测肌层浸润性膀胱癌的准确性。方法本研究涵盖了113名经过特殊膀胱磁共振成像(mpMRI)检测的病例。在评估过程中,由两位资深...目的本研究旨在探讨多参数MRI膀胱影像报告与数据系统(vesical imaging reporting and data system,VI-RADS)预测肌层浸润性膀胱癌的准确性。方法本研究涵盖了113名经过特殊膀胱磁共振成像(mpMRI)检测的病例。在评估过程中,由两位资深的放射学专家遵循VI-RADS系统的指导方针,独立完成了对影像资料的评分工作。通过t检验和卡方检验初步比较临床病理数据,再用多因素logistic回归模型来确定与肌层浸润性膀胱癌相关预测因素。本研究通过受试者工作特征(receiver operating characteristic,ROC)曲线的分析方法,评估了VI-RADS评分系统在识别膀胱癌是否侵犯肌层方面的准确性。研究中计算了ROC曲线下的面积(area under the curve,AUC),以此来衡量诊断模型的整体性能。此外,根据不同的评分界限,我们进一步分析了诊断的敏感性(sensitivity)、特异性(specificity)、以及预测膀胱癌肌层浸润的阳性(positive predictive value,PPV)和阴性(negative predictive value,NPV)预测值。结果本研究共纳入113例患者,男91例,女22例。多变量logistic回归模型分析结果显示只有高的VI-RADS评分与肌层浸润性膀胱癌有关(优势比为8.56;P<0.001)。VIRADS评分ROC曲线下面积为0.91。VI-RADS评分根据不同的阈值来定义肌层浸润性膀胱癌。当把VI-RADS≥3设置为阈值时,敏感度、特异度、阳性预测值(positive predictive Value,PPV)、阴性预测值(negative predictive value,NPV)分别为90%、78%、60%、96%。MIBC的分界点移至VIRADS≥4,则敏感度、特异度、PPV、NPV分别为90%、82%、64%、96%。结论VI-RADS评分能够较准确地预测肌层浸润性膀胱癌,是一种有效的、有前途的术前预测肌层浸润性膀胱癌的方法。展开更多
Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast ...Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast nodules of BI-RADS 3 or above were selected as the research subjects.After pathological diagnosis,24 cases were malignant breast nodules of BI-RADS 3 or above,while 139 cases were benign breast nodules of BI-RADS 3 or above.The diagnosis rate of malignant and benign breast nodules of BI-RADS 3 or above,including 95%CI,was observed and analyzed.Results:The malignant and benign detection rates of conventional ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of ultrasound imaging were 93.18%and 87.50%,respectively,with 95%CIs greater than 0.7.Conclusion:Ultrasound imaging can help improve the diagnostic accuracy of benign and malignant breast nodules of BI-RADS 3 and above and reduce the misdiagnosis rate.展开更多
目的探讨多参数MRI(multi-parametric MRI,mp-MRI)膀胱影像报告和数据系统(Vesical Imaging-Reporting and Data System,VI-RADS)对预测膀胱癌肌层浸润的价值,并分析发生于输尿管口区膀胱癌肌层侵犯的征象。材料与方法回顾性分析病理证...目的探讨多参数MRI(multi-parametric MRI,mp-MRI)膀胱影像报告和数据系统(Vesical Imaging-Reporting and Data System,VI-RADS)对预测膀胱癌肌层浸润的价值,并分析发生于输尿管口区膀胱癌肌层侵犯的征象。材料与方法回顾性分析病理证实的87例(共122个病灶)行mp-MRI检查的膀胱癌患者的资料。由两组阅片者采用双盲方法对每个病灶进行VI-RADS独立评分。采用Cohen's Kappa检验分析两组阅片者VI-RADS评分的一致性;使用受试者工作特征(receiver operating characteristic,ROC)曲线分析VI-RADS评分诊断膀胱癌肌层浸润的效能。分析位于输尿管膀胱入口处肿瘤与输尿管的关系。结果两组阅片者VI-RADS评分一致性良好(Kappa值=0.727,P<0.001),ROC曲线下面积(area under the curve,AUC)分别为0.880[95%置信区间(confidence interval,CI):0.808~0.932]和0.905(95%CI:0.838~0.950)。根据ROC分析,以VI-RADS≥3分为阈值,其Youden指数为67.8%,预测膀胱癌肌层浸润的敏感度为76.7%,特异度为91.1%,阳性预测值82.5%,阴性预测值87.8%。本组病例有29个肿瘤位于膀胱输尿管开口区,表现为“蒂包埋输尿管口”的7个肿瘤中,85.7%(6/7)为非肌层浸润膀胱癌;表现为“肿瘤与输尿管口分界不清”的22个肿瘤中,95.5%(21/22)为肌层浸润膀胱癌。结论多参数磁共振VI-RADS在不同阅片者之间具有较高的一致性,并且能有效地预测膀胱癌的肌层侵犯。对发生于输尿管口的肿瘤需认真分析“蒂”或“肿瘤组织”与输尿管口的关系。展开更多
目的通过Meta分析探讨MRI膀胱影像报告和数据系统(VI-RADS)对肌层浸润性膀胱癌(MIBC)的诊断效能。方法检索PubMed、Web of Science、Embase、Ebsco、中国生物医学文献数据库、中国知网、万方及维普数据库2018年1月1日—2020年4月11日有...目的通过Meta分析探讨MRI膀胱影像报告和数据系统(VI-RADS)对肌层浸润性膀胱癌(MIBC)的诊断效能。方法检索PubMed、Web of Science、Embase、Ebsco、中国生物医学文献数据库、中国知网、万方及维普数据库2018年1月1日—2020年4月11日有关VI-RADS诊断MIBC的中英文文献。对纳入文献进行数据提取和质量评估后,采用Stata15.1统计软件计算所纳入研究的合并敏感度、合并特异度、合并阳性似然比、合并阴性似然比及诊断比值比。绘制森林图和综合受试者操作特征(SROC)曲线,并计算相应曲线下面积(AUC)。采用I~2评估文献之间的异质性大小。采用回归分析和亚组分析探讨异质性来源。结果最终纳入12项国内外研究,包括1508例病人(共1624个病灶)。纳入研究的合并敏感度、合并特异度、合并阳性似然比、合并阴性似然比、诊断试验比值比及SROC曲线下面积分别为0.85(95%CI:0.81~0.88)、0.92(95%CI:0.89~0.94)、11.1(95%CI:8.0~15.2)、0.16(95%CI:0.13~0.21)、68(95%CI:44~106)及0.89(95%CI:0.85~0.91)。Meta回归分析显示,MRI场强(P=0.01)与诊断阈值(P=0.01)可能为异质性来源。亚组分析结果显示,使用3.0 T MR时VI-RADS诊断MIBC的合并敏感度及特异度均高于使用1.5 T或1.5 T/3.0 T MR。以VI-RADS≥3分为阈值诊断MIBC的合并敏感度高于VI-RADS≥4分,合并特异度则低于VI-RADS≥4分。Deek’s漏斗图提示纳入研究不存在明显发表偏倚(P=0.41)。结论MRI VI-RADS评分对MIBC的诊断具有较高的敏感度和特异度。展开更多
膀胱癌是泌尿系统发病率最高的恶性肿瘤,因对其进行准确的分类及分期较为困难,使膀胱癌患者的诊治面临着诸多问题。随着现代医疗技术的不断发展和完善,2018年,基于多参数磁共振成像(multi-parametric magnetic resonance imaging, mpMRI...膀胱癌是泌尿系统发病率最高的恶性肿瘤,因对其进行准确的分类及分期较为困难,使膀胱癌患者的诊治面临着诸多问题。随着现代医疗技术的不断发展和完善,2018年,基于多参数磁共振成像(multi-parametric magnetic resonance imaging, mpMRI)技术所提出的膀胱影像报告和数据系统(Vesical Imaging-Reporting and Data System, VI-RADS)得到了日本腹部放射学会、欧洲泌尿外科协会及欧洲泌尿外科影像学会的共同认可。VI-RADS评分可对膀胱癌进行较为准确的分类,为临床医生对膀胱癌患者的治疗提供指导。本文就VI-RADS在膀胱癌中的诊断效能、VI-RADS参数及诊断膀胱癌时最佳临界值的选择、VI-RADS与影像组学的联合等研究现状及进展进行综述,并对肿瘤大小和肿瘤所在部位对VI-RADS的影响等未来研究方向进行展望,旨在为该领域研究提供参考。展开更多
目的评估基于多参数磁共振的膀胱影像-报告和数据系统(vesical imaging-reporting and data system,VI-RADS)对膀胱癌肌层浸润与否的诊断预测价值。方法收集重庆大学附属肿瘤医院2017年1月至2021年3月行多参数磁共振检查并完成经尿道膀...目的评估基于多参数磁共振的膀胱影像-报告和数据系统(vesical imaging-reporting and data system,VI-RADS)对膀胱癌肌层浸润与否的诊断预测价值。方法收集重庆大学附属肿瘤医院2017年1月至2021年3月行多参数磁共振检查并完成经尿道膀胱肿瘤切除术(transurethral resection of bladder tumor,TURBT)或根治性膀胱切除术的278例膀胱病变患者临床资料;不同影像学医师分别进行磁共振VI-RADS评分,Kappa检验其一致性;分析VI-RADS评分与病理结果的吻合度;采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析VI-RADS各评分诊断肌层浸润性膀胱癌的效能;比较不同手术方式获取的病理组织与VI-RADS评分吻合度。结果两位影像评估者VI-RADS评分一致性较好(符合率为79.86%,Kappa值=0.7508,P<0.001)。ROC曲线分析显示,VI-RADS评分≥3时预测肌层浸润性膀胱癌的曲线下面积为0.774,约登指数为54.78%,敏感度为96.16%,特异度为58.62%,阳性预测值(positive predictive value,PPV)为58.14%,阴性预测值(negative predictive value,NPV)为96.23%。根治性膀胱切除术获得的病理结果与VI-RADS评分吻合度高达92.85%,显著高于行TURBT术的79.81%(P<0.05)。结论术前多参数磁共振VI-RADS评分具有良好的一致性和稳定性,与术后病理吻合度高;VI-RADS评分≥3分对肌层浸润性膀胱癌的预测价值较好,可指导临床手术选择方式。展开更多
Objective To measure the intraobserver concordance of an experienced genitourinary radiologist reporting of multiparametric magnetic resonance imaging of the prostate(mpMRIp)scans over time.Methods An experienced geni...Objective To measure the intraobserver concordance of an experienced genitourinary radiologist reporting of multiparametric magnetic resonance imaging of the prostate(mpMRIp)scans over time.Methods An experienced genitourinary radiologist re-reported his original 100 consecutive mpMRIp scans using Prostate Imaging-Reporting and Data System version 2(PI-RADS v2)after 5 years of further experience comprising>1000 scans.Intraobserver agreement was measured using Cohen's kappa.Sensitivity,specificity,negative predictive value(NPV),positive predictive value(PPV),and accuracy were calculated,and comparison of sensitivity was performed using McNemar's test.Results Ninety-six mpMRIp scans were included in our final analysis.Of the 96 patients,53(55.2%)patients underwent subsequent biopsy(n=43)or prostatectomy(n=15),with 73 lesions targeted.Moderate agreement(Cohen's kappa 0.55)was seen in the number of lesions identified at initial reporting and on re-reading(81 vs.39 total lesions;and 71 vs.37 number of PI-RADS≥3 lesions).For clinically significant prostate cancer,re-reading demonstrated an increase in specificity(from 43%to 89%)and PPV(from 62%to 87%),but a decrease in sensitivity(from 94%to 72%,p=0.01)and NPV(from 89%to 77%).Conclusion The intraobserver agreement for a novice to experienced radiologist reporting mpMRIp using PI-RADS v2 is moderate.Reduced sensitivity is off-set by improved specificity and PPV,which validate mpMRIp as a gold standard for prebiopsy screening.展开更多
文摘Background:Vesical Imaging-Reporting and Data System(Ⅵ-RADS)was developed as a structured reporting tool to anticipate the possibility of muscle invasion.This study is aimed to investigate the diagnostic accuracy ofⅥ-RADS for discriminating T2 from T1 bladder cancer.Materials and methods:Scopus,Web of Science,PubMed,and Embase were searched on October 4,2021,for studies with the following characteristics:(1)bladder cancer patient population,(2)Ⅵ-RADS as an index test,(3)retransurethral resection of bladder tumor/cystectomy as a reference,and(4)adequateⅥ-RADS score data for T1 and T2 lesions.The analyses were performed using the binary regression model of MIDAS in Stata.Results:Six studies with 624 magnetic resonance imaging reports were included.The receiver operating characteristics curve for differentiation of T2 from T1 bladder cancer showed an area under the curve of 0.93(95%confidence interval[CI],0.91-0.95)for aⅥ-RADS≥3 and 0.75(95%CI,0.71-0.79)for aⅥ-RADS≥4.AⅥ-RADS≥3 showed high sensitivity of 93%(95%CI,85%-97%),specificity of 61%(95%CI,30%-86%),positive likelihood ratio of 2.4(95%CI,1.1-5.3),and negative likelihood ratio of 0.11(95%CI,0.05-0.24).A total of 10.4%of T2 lesions were scored asⅥ-RADS 2,while 10%of T1 lesions were scored asⅥ-RADS 4 or 5.Conclusions:TheⅥ-RADS≥3 has high accuracy and sensitivity for detecting muscle invasion in borderline populations of T1 or T2 bladder cancer.Thus,theⅥ-RADS could be a good non-invasive screening test for the detection of T2 urothelial lesions.
文摘Objective:Vesical Imaging Reporting and Data System(VIRADS)score was developed to standardize the reporting and staging of bladder tumors on pre-operative multiparametric magnetic resonance imaging.It helps in avoiding unnecessary repeat transurethral resection of bladder tumor in high-risk non-muscle-invasive bladder cancer patients.This study was done to determine the validity of VIRADS score prospectively for the diagnosis of muscleinvasive bladder cancer.Methods:This study was conducted from March 2019 to March 2020 at Sawai Man Singh Medical College and Hospital,Jaipur,Rajasthan,India.Patients admitted with the provisional diagnosis of bladder tumor were included as participants.All these patients underwent a 3 Tesla mpMRI to obtain a VIRADS score before they underwent transurethral resection of bladder tumor and these data were analyzed to evaluate the correlation of pre-operative VIRADS score with mus-cle invasiveness of the tumor in final biopsy report.Results:A cut-off of VIRADS≥4 for prediction of detrusor muscle invasion yielded a sensitivity of 79.4%,specificity of 94.2%,positive predictive value of 90.0%,negative predictive value of 87.5%,and diagnostic accuracy of 86.4%.A cut off of VIRADS≥3 for prediction of detrusor muscle invasion yielded a sensitivity of 91.2%,specificity of 78.8%,positive predictive value of 73.8%,negative predictive value of 93.2%,and accuracy of 83.7%.The receiver operating curve showed the area under the curve to be 0.922(95%confidence interval:0.862e0.983).Conclusion:VIRADS score appears to be an excellent and effective pre-operative radiological tool for the prediction of detrusor muscle invasion in bladder cancer.
文摘目的本研究旨在探讨多参数MRI膀胱影像报告与数据系统(vesical imaging reporting and data system,VI-RADS)预测肌层浸润性膀胱癌的准确性。方法本研究涵盖了113名经过特殊膀胱磁共振成像(mpMRI)检测的病例。在评估过程中,由两位资深的放射学专家遵循VI-RADS系统的指导方针,独立完成了对影像资料的评分工作。通过t检验和卡方检验初步比较临床病理数据,再用多因素logistic回归模型来确定与肌层浸润性膀胱癌相关预测因素。本研究通过受试者工作特征(receiver operating characteristic,ROC)曲线的分析方法,评估了VI-RADS评分系统在识别膀胱癌是否侵犯肌层方面的准确性。研究中计算了ROC曲线下的面积(area under the curve,AUC),以此来衡量诊断模型的整体性能。此外,根据不同的评分界限,我们进一步分析了诊断的敏感性(sensitivity)、特异性(specificity)、以及预测膀胱癌肌层浸润的阳性(positive predictive value,PPV)和阴性(negative predictive value,NPV)预测值。结果本研究共纳入113例患者,男91例,女22例。多变量logistic回归模型分析结果显示只有高的VI-RADS评分与肌层浸润性膀胱癌有关(优势比为8.56;P<0.001)。VIRADS评分ROC曲线下面积为0.91。VI-RADS评分根据不同的阈值来定义肌层浸润性膀胱癌。当把VI-RADS≥3设置为阈值时,敏感度、特异度、阳性预测值(positive predictive Value,PPV)、阴性预测值(negative predictive value,NPV)分别为90%、78%、60%、96%。MIBC的分界点移至VIRADS≥4,则敏感度、特异度、PPV、NPV分别为90%、82%、64%、96%。结论VI-RADS评分能够较准确地预测肌层浸润性膀胱癌,是一种有效的、有前途的术前预测肌层浸润性膀胱癌的方法。
文摘Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast nodules of BI-RADS 3 or above were selected as the research subjects.After pathological diagnosis,24 cases were malignant breast nodules of BI-RADS 3 or above,while 139 cases were benign breast nodules of BI-RADS 3 or above.The diagnosis rate of malignant and benign breast nodules of BI-RADS 3 or above,including 95%CI,was observed and analyzed.Results:The malignant and benign detection rates of conventional ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of ultrasound imaging were 93.18%and 87.50%,respectively,with 95%CIs greater than 0.7.Conclusion:Ultrasound imaging can help improve the diagnostic accuracy of benign and malignant breast nodules of BI-RADS 3 and above and reduce the misdiagnosis rate.
文摘目的探讨多参数MRI(multi-parametric MRI,mp-MRI)膀胱影像报告和数据系统(Vesical Imaging-Reporting and Data System,VI-RADS)对预测膀胱癌肌层浸润的价值,并分析发生于输尿管口区膀胱癌肌层侵犯的征象。材料与方法回顾性分析病理证实的87例(共122个病灶)行mp-MRI检查的膀胱癌患者的资料。由两组阅片者采用双盲方法对每个病灶进行VI-RADS独立评分。采用Cohen's Kappa检验分析两组阅片者VI-RADS评分的一致性;使用受试者工作特征(receiver operating characteristic,ROC)曲线分析VI-RADS评分诊断膀胱癌肌层浸润的效能。分析位于输尿管膀胱入口处肿瘤与输尿管的关系。结果两组阅片者VI-RADS评分一致性良好(Kappa值=0.727,P<0.001),ROC曲线下面积(area under the curve,AUC)分别为0.880[95%置信区间(confidence interval,CI):0.808~0.932]和0.905(95%CI:0.838~0.950)。根据ROC分析,以VI-RADS≥3分为阈值,其Youden指数为67.8%,预测膀胱癌肌层浸润的敏感度为76.7%,特异度为91.1%,阳性预测值82.5%,阴性预测值87.8%。本组病例有29个肿瘤位于膀胱输尿管开口区,表现为“蒂包埋输尿管口”的7个肿瘤中,85.7%(6/7)为非肌层浸润膀胱癌;表现为“肿瘤与输尿管口分界不清”的22个肿瘤中,95.5%(21/22)为肌层浸润膀胱癌。结论多参数磁共振VI-RADS在不同阅片者之间具有较高的一致性,并且能有效地预测膀胱癌的肌层侵犯。对发生于输尿管口的肿瘤需认真分析“蒂”或“肿瘤组织”与输尿管口的关系。
文摘目的通过Meta分析探讨MRI膀胱影像报告和数据系统(VI-RADS)对肌层浸润性膀胱癌(MIBC)的诊断效能。方法检索PubMed、Web of Science、Embase、Ebsco、中国生物医学文献数据库、中国知网、万方及维普数据库2018年1月1日—2020年4月11日有关VI-RADS诊断MIBC的中英文文献。对纳入文献进行数据提取和质量评估后,采用Stata15.1统计软件计算所纳入研究的合并敏感度、合并特异度、合并阳性似然比、合并阴性似然比及诊断比值比。绘制森林图和综合受试者操作特征(SROC)曲线,并计算相应曲线下面积(AUC)。采用I~2评估文献之间的异质性大小。采用回归分析和亚组分析探讨异质性来源。结果最终纳入12项国内外研究,包括1508例病人(共1624个病灶)。纳入研究的合并敏感度、合并特异度、合并阳性似然比、合并阴性似然比、诊断试验比值比及SROC曲线下面积分别为0.85(95%CI:0.81~0.88)、0.92(95%CI:0.89~0.94)、11.1(95%CI:8.0~15.2)、0.16(95%CI:0.13~0.21)、68(95%CI:44~106)及0.89(95%CI:0.85~0.91)。Meta回归分析显示,MRI场强(P=0.01)与诊断阈值(P=0.01)可能为异质性来源。亚组分析结果显示,使用3.0 T MR时VI-RADS诊断MIBC的合并敏感度及特异度均高于使用1.5 T或1.5 T/3.0 T MR。以VI-RADS≥3分为阈值诊断MIBC的合并敏感度高于VI-RADS≥4分,合并特异度则低于VI-RADS≥4分。Deek’s漏斗图提示纳入研究不存在明显发表偏倚(P=0.41)。结论MRI VI-RADS评分对MIBC的诊断具有较高的敏感度和特异度。
文摘膀胱癌是泌尿系统发病率最高的恶性肿瘤,因对其进行准确的分类及分期较为困难,使膀胱癌患者的诊治面临着诸多问题。随着现代医疗技术的不断发展和完善,2018年,基于多参数磁共振成像(multi-parametric magnetic resonance imaging, mpMRI)技术所提出的膀胱影像报告和数据系统(Vesical Imaging-Reporting and Data System, VI-RADS)得到了日本腹部放射学会、欧洲泌尿外科协会及欧洲泌尿外科影像学会的共同认可。VI-RADS评分可对膀胱癌进行较为准确的分类,为临床医生对膀胱癌患者的治疗提供指导。本文就VI-RADS在膀胱癌中的诊断效能、VI-RADS参数及诊断膀胱癌时最佳临界值的选择、VI-RADS与影像组学的联合等研究现状及进展进行综述,并对肿瘤大小和肿瘤所在部位对VI-RADS的影响等未来研究方向进行展望,旨在为该领域研究提供参考。
基金This research has been kindly supported by a grant from the St Vincent's Research Endowment Fund(approval number 55.2014).
文摘Objective To measure the intraobserver concordance of an experienced genitourinary radiologist reporting of multiparametric magnetic resonance imaging of the prostate(mpMRIp)scans over time.Methods An experienced genitourinary radiologist re-reported his original 100 consecutive mpMRIp scans using Prostate Imaging-Reporting and Data System version 2(PI-RADS v2)after 5 years of further experience comprising>1000 scans.Intraobserver agreement was measured using Cohen's kappa.Sensitivity,specificity,negative predictive value(NPV),positive predictive value(PPV),and accuracy were calculated,and comparison of sensitivity was performed using McNemar's test.Results Ninety-six mpMRIp scans were included in our final analysis.Of the 96 patients,53(55.2%)patients underwent subsequent biopsy(n=43)or prostatectomy(n=15),with 73 lesions targeted.Moderate agreement(Cohen's kappa 0.55)was seen in the number of lesions identified at initial reporting and on re-reading(81 vs.39 total lesions;and 71 vs.37 number of PI-RADS≥3 lesions).For clinically significant prostate cancer,re-reading demonstrated an increase in specificity(from 43%to 89%)and PPV(from 62%to 87%),but a decrease in sensitivity(from 94%to 72%,p=0.01)and NPV(from 89%to 77%).Conclusion The intraobserver agreement for a novice to experienced radiologist reporting mpMRIp using PI-RADS v2 is moderate.Reduced sensitivity is off-set by improved specificity and PPV,which validate mpMRIp as a gold standard for prebiopsy screening.
