第一版和第二版前列腺影像报告和数据系统评分对移行带前列腺癌的诊断价值  

Diagnostic value of prostate imaging reporting and data system version 1 and 2 in detection of prostate cancer in transition

作　　者：王希明[1] 包婕[1] 朱默[1] 平小夏[1] 胡春洪[1] 侯建全[2] 席启林[2] 董凤林[3] 孙军[3] 赵文露[4] 沈钧康[4] 

机构地区：[1]苏州大学附属第一医院影像中心,215006 [2]苏州大学附属第一医院泌尿外科,215006 [3]苏州大学附属第一医院超声科,215006 [4]苏州大学附属第二医院影像中心

出　　处：《中华放射学杂志》2017年第6期427-431,共5页Chinese Journal of Radiology

摘　　要：目的探讨第一版前列腺影像报告和数据系统（PI-RADS V1）和第二版前列腺影像报告和数据系统（PI-RADS V2）对移行带前列腺癌（PCa）的诊断价值。 方法前瞻性收集临床拟诊为PCa需要行多参数MRI（MpMRI）检查，病灶位于移行带且最终诊断经MpMRI与经直肠超声（TRUS）融合穿刺活检结果证实，每个病灶至少有一个序列的PI-RADS V1评分≥3分的77例患者纳入研究。患者均行MpMRI检查，并分别对每个病灶进行PI-RADS V1、PI-RADS V2评分，并采用独立样本t检验比较PCa与前列腺增生（BPH）患者的PI-RADS V1和PI-RADS V2评分间的差异。以融合穿刺病理结果为标准，评价PI-RADS V1、PI-RADS V2评分鉴别诊断移行带PCa和BPH的效能。结果77例中，移行带PCa患者31例（32个病灶），BPH 46例（51个病灶）。PCa患者的PI-RADS V1、PI-RADS V2评分分别为（11.50±2.79）、（4.28±0.99）分，BPH患者的PI-RADS V1、PI-RADS V2评分分别为（7.51±1.63）、（2.61±0.67）分，PCa患者的PI-RADS V1、PI-RADS V2均高于BPH组，PCa和BPH患者的PI-RADS V1均高于PI-RADS V2，差异均有统计学意义（P均〈0.05）。PI-RADS V1和PI-RADS V2评分鉴别诊断PCa和BPH的ROC下面积分别为0.869和0.888。以11分为PI-RADS V1诊断临界值，敏感度和特异度分别为68.8%（22/32）和96.1%（49/51）；以4分为PI-RADS V2诊断临界值，敏感度和特异度分别为75.0%（24/32）和90.2%（46/51）。结论PI-RADS V2对移行带PCa的诊断效能优于PI-RADS V1。ObjectiveTo evaluate the diagnostic value of prostate imaging reporting and data system version 1 （PI-RADS V1） and version 2 （PI-RADS V2） for detection of prostate cancer （PCa） in the transition zone （TZ）.MethodsSeventy-seven patients with suspicious lesions in TZ on mpMRI were scored according to the PI-RADS system （V1 and V2） before MR-TRUS fusion guided biopsy prospectively. In all of the patients with suspicious tumors, respectively at least one lesion with a PI-RADS V1 assessment category of ≥3, was selected for biopsy.Independent sample t test was used to compare scores of PI-RADS V1 and V2 between PCa and benign prostatic hyperplasia （BPH）. The diagnostic performance of PI-RADS V1 and V2 for detection of PCa in the transition zone was compared by analyzing ROC basing on the results of MR-TRUS fusion guided biopsy.ResultsA cohort of 77 patients was performed including 31 cases of PCa （32 cores） and 46 cases of BPH （51 cores）. PCa （V1：11.50±2.79; V2：4.28±0.99） had significantly higher scores of both PI-RADS V1 and PI-RADS V2 than BPH（V1：7.51±1.63; V2：2.61±0.67） （P〈0.05）. Using a PI-RADS V1 score cut-off ≥ 11, sensitivity and specificity in group PCa and BPH were calculated, which were 68.8%（22/32） and 96.1%（49/51） with a area under curve of 0.869; using a PI-RADS V2 score cut-off ≥ 4, which were 75.0% （24/32） and 90.2% （46/51） with a area under curve of 0.888, respectively.ConclusionsPI-RADS system can indicate the likelihood of PCa of suspicious lesions in TZ on Mp-MRI. PI-RADS V2 perform better than V1 for the assessment of prostate cancer in TZ.

关 键 词：前列腺肿瘤 磁共振成像 前列腺影像报告和数据系统 对比研究 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]