双参数磁共振成像在前列腺癌检出方面的应用——基于前列腺癌根治术病理大切片为对照的研究  

Application of biparametric magnetic resonance imaging in the detection of prostate cancer:a contrastive study based on whole mount section after radical prostatectomy

作　　者：韩思圆 李春媚[1] 刘明[3] 张伟[4] 朱锦霞 陈敏[1,2] HAN Siyuan;LI Chunmei;LIU Ming;ZHANG Wei;ZHU Jinxia;CHEN Min(Department of Radiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Graduate School of Peking Union Medical College,Beijing 100005,China;Department of Urology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Pathology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;MR Collaboration,Siemens Healthcare,Beijing 100102,China)

机构地区：[1]北京医院放射科国家老年医学中心中国医学科学院老年医学研究院,北京100730 [2]北京协和医学院研究生院,北京100005 [3]北京医院泌尿外科国家老年医学中心中国医学科学院老年医学研究院,北京100730 [4]北京医院病理科国家老年医学中心中国医学科学院老年医学研究院,北京100730 [5]西门子医疗系统有限公司MR科研合作部,北京100102

出　　处：《磁共振成像》2021年第5期30-34,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的探索双参数磁共振成像(biparametric magnetic resonance imaging,bpMRI)在前列腺癌(prostate cancer,PCa)检出方面的应用。材料与方法收集我院2017年5月至2019年9月期间临床怀疑前列腺癌,行术前常规bpMRI检查,之后行前列腺癌根治术并行病理大切片的患者进行回顾性分析,将包括T2WI、扩散加权成像(diffusion weighted imaging,DWI)及ADC在内的双参数MR图像与病理大切片图像进行匹配分析,探索bpMRI在前列腺癌灶检出方面的敏感性,并分析影响前列腺癌灶检出的因素。结果67例患者,病理大切片确认病灶123个,术前bpMRI检出病灶94个,直径>1 cm的癌灶检出率为92.1%,Gleason评分大于3+3的前列腺癌检出率为84.3%。癌灶大小(P<0.001)和Gleason评分(P=0.008)分别为癌灶检出的独立预测因子,移行带癌灶检出率与外周带癌灶检出率无统计学差异。结论bpMRI对前列腺癌灶的检出有较高的敏感性,尤其是对直径大于1 cm或Gleason评分>6分的病灶敏感性高。Objective:To explore the application of biparametric magnetic resonance imaging(bpMRI)in the detection of prostate cancer(PCa)based on whole-mount histopathology.Materials and Methods:From May 2017 to September 2019,a retrospective analysis was used to identify the predictive factors affecting the detection of prostate cancer,based on a database correlating lesion-specific results from bpMRI co-registered with whole-mount pathology(WMP)prostatectomy specimens.Results:In 67 patients,123 lesions were confirmed by whole-mount pathology.Tumor detection increases with tumor size and Gleason score.The detection rate of 1.0 cm foci was 92.1%,and that of Gleason score greater than 3+3 was 84.3%.Cancer focal size(P<0.001)and Gleason score(P=0.008)were independent predictors of tumor detection,respectively.There was no statistical difference in the detection rate between the transitional zone and peripheral zone.Conclusions:bp MRI is highly sensitive to the detection of prostate cancer,especially for foci larger than 1 cm in diameter or Gleason score>6.

关 键 词：前列腺癌 双参数磁共振成像 癌灶检出 病理大切片 

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]