基于PI-RADS v2研究多参数磁共振成像在前列腺癌中的诊断价值  

Value of multiparametric magnetic resonance imaging in prostate cancer detection based on prostate imaging reporting and data system version 2

作　　者：曾浩[1] 杨国庆[1] 付泉水 陈洪[1] 赵林伟[1] 牛翔科 

机构地区：[1]四川省遂宁市中心医院放射影像科,四川遂宁629000 [2]成都大学附属医院放射科,四川成都610081

出　　处：《中国临床医学影像杂志》2017年第1期60-63,共4页Journal of China Clinic Medical Imaging

摘　　要：目的 :探索前列腺影像报告和数据系统第二版(PI-RADS v2)在前列腺疾病中的评分一致性及其在前列腺癌中的诊断价值。方法:回顾性分析经超声引导下穿刺活检病理证实的前列腺病变176例的多参数磁共振成像表现。由两位观察者盲法对病灶进行评分。Kappa检验对两位观察者评分一致性进行分析;采用受试者工作特征曲线分析PI-RADS v2在前列腺癌中的诊断价值。结果:PI-RADS v2在外周带和移行带病灶中的评分一致性Kappa系数分别为0.63和0.60;对于外周带和移行带癌,PI-RADS v2诊断敏感性、特异性、阳性预测值、阴性预测值分别为85%,79%,76%,87%和81%,69%,64%,72%。结论:对于前列腺外周带和移行带病灶,PI-RADS v2观察者间一致性均为高度。对于外周带癌,PI-RADS v2可取得较高的诊断敏感性和阴性预测值;对于移行带癌,虽然诊断敏感性较高,但仍需进一步探索增加诊断特异性的方法。Objective： To evaluate interobserver agreement and diagnosis value with the use of updated Prostate Imaging Reporting and Data System version 2 （PI-RADS v2） for the detection of prostate cancer. Methods： The muhiparametrie MRI images of 176 histologically proven prostate lesions were analyzed retrospectively. Prostate biopsy was performed under the guidance of TRUS. Biopsied lesions were evaluated according to the PI-RADS v2 and compared with histopathological findings by two observers blindly. Cohen＇s Kappa statistics were calculated to evaluate the consistency of the two observers and the area under the receiver operating characteristic curve （ROC-AUC） was calculated to evaluate the diagnosis value of PI-RADS v2. Results： Interobserver agreement for peripheral zone and transition zone lesions were 0.63 and 0.60, respectively. For peripheral zone cancer and transition zone cancer, the sensitivity, specificity, PPV, and NPV were 85%, 79%, 76%, 87% and 81%, 69%, 64%, 72%, respectively. Conclusion： The application of updated PI-RADS v2 provides high interobserver agreement for detecting peripheral zone and transition zone lesions. Futhermore, PI-RADS v2 can achieve relatively high sensitivity and NPV in the diagnosis of peripheral zone cancer. For transition zone cancer, although PI-RADS v2 can achieve relatively high sensitivity, the specificity needs to be improved.

关 键 词：前列腺肿瘤 磁共振成像 

分 类 号：R737-25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]