利用PI-RADS评分评估3T MR高b值DWI对前列腺癌的诊断价值  

Diagnostic Value of High b-value 3.0T Diffusion-Weighted MR in Prostate Cancer According to PI-RADS

作　　者：辛毅[1] 董海霞[1] 蒋瑞生[1] 

机构地区：[1]潍坊医学院附属益都中心医院CT-MR科

出　　处：《中国医学计算机成像杂志》2016年第2期152-156,共5页Chinese Computed Medical Imaging

摘　　要：目的:以PI-RADS积分为标准探讨高b值DWI对前列腺癌的诊断及鉴别价值。方法:回顾性分析行多b值DWI序列扫描并经病理证实的前列腺癌32例,良性病变26例;根据前列腺影像报告和数据系统(PI-RADS)中DWI的评分标准由两名医师对前列腺病变进行评分,分析不同评估者间一致性,计算b值分别为400 s/mm2,1000 s/mm2,1500 s/mm2,2000 s/mm2,3000 s/mm2时DWI对前列腺癌的诊断效能。结果:两名医师对前列腺病变评估的Kappa值依次为0.464,0.621,0.759,0.759,0.862。高b值(1500 s/mm2,2000 s/mm2,3000 s/mm2)DWI对前列腺癌诊断的敏感度、特异度、准确率、阳性及阴性预测值均显著高于传统b值序列(400 s/mm2,1000 s/mm2)。结论:3T磁共振高b值DWI有助于对前列腺异常信号的解读,能够增加前列腺癌诊断的正确性。Purpose：To investigate the diagnostic value of high b-value 3.0T Diffusion Weighted MR in prostate cancer according to prostate imaging reporting and data system（PI-RADS）. Methods： A total of 58 patients, 32 with prostate cancer and 26 with benign lesions, were retrospectively analyzed. Multi-b-value DWI sequence with b-values = 0 s/mm^2, 400 s/mm^2,, 1000 s/mm^2,, 1500 s/mm^2,, 2000 s/mm^2,, 3000 s/mm^2,were performed in all patients on a 3.0T MR scanner before operation. Two physicians assessed the score of every lesion in prostate according to the PI-RADS used in China. The readers＇ agreement was assessed using Cohen＇s kappa test. The efficacy of DWI with different b-values in the diagnosis of prostate cancer was calculated. Results：The Kappa value were 0.464, 0.621, 0.759, 0.759 and 0.862 when b-values changing from 400 s/mm^2, to 3000 s/mm^2,. The sensitivity, specificity, accuracy, positive and negative predictive value of DWI with high b-values（1500 s/mm^2,, 2000 s/mm^2,, 3000 s/mm^2,） were all higher than those in the DWI with traditional b-values（400 s/mm^2,, 1000 s/mm^2,）. Conclusion：DWI with high b-values in 3.0T MR is very helpful in the interpretation of abnormal diffusion signals in prostate, which can improve the diagnostic accuracy of prostate cancer.

关 键 词：前列腺肿瘤 弥散磁共振成像 前列腺影像报告和数据系统 

分 类 号：R445.2[医药卫生—影像医学与核医学]