第二版前列腺影像报告和数据系统联合应用表观扩散系数在前列腺癌诊断中的价值研究  

Value of PI-RADS v2 combined with ADC in diagnosis of prostate cancer

作　　者：周理乾[1] 马少君[1] 樊国峰[1] 樊民义[1] ZHOU Liqian;MA Shaojun;FAN Guofeng;FAN Minyi(Department of Radiology,Shaanxi Provincial People’s Hospital,Xi’an 710068,China)

机构地区：[1]陕西省人民医院放射科,陕西西安710068

出　　处：《陕西医学杂志》2021年第7期802-806,810,共6页Shaanxi Medical Journal

摘　　要：目的:评估第二版前列腺影像报告和数据系统(PI-RADS v2)联合表观扩散系数(ADC)或ADC分类对前列腺癌(PCa)的诊断价值。方法:回顾分析前列腺特异抗原(PSA)异常患者329例,所有病例均先行3.0 T多参数磁共振成像(mpMRI)检查,再行经直肠超声引导下前列腺穿刺。以穿刺病理作为金标准,使用Logistic回归对PI-RADS v2评分联合ADC值或分类进行分析,运用受试者工作特征(ROC)比较PI-RADS v2评分联合ADC值或分类与单独PI-RADS v2评分、ADC值或分类曲线下面积(AUC)。结果:纳入病灶394个,经穿刺病理证实为194个PCa病灶和200个良性病灶。Logistic回归分析显示PI-RADS v2评分、ADC值或分类均为PCa的独立预测指标(均P<0.01)。PI-RADS v2评分+ADC值与PI-RADS v2评分+ADC分类AUC值比较差异无统计学意义(P>0.05),但均高于单独PI-RADS v2评分(均P<0.05)。对于外周带和移行带病灶亦如此(均P<0.05)。PI-RADS v2评分+ADC分类在PI-RADS v2评分为4分时AUC值最大。PI-RADS v2评分+ADC分类的部分ROC曲线下面积(pAUC)为单独PI-RADS v2评分的3倍。结论:ADC能明显提高PI-RADS v2评分对PCa的预测效能,尤其对PI-RADS v2评分为4分的病灶。Objective:To evaluate the efficiency of PI-RADS v2 in combination with ADC in the diagnosis of prostate cancer(PCa).Methods:A retrospective analysis of 329 patients with abnormal PSA was performed.All cases underwent 3.0 T multi-parameter magnetic resonance imaging(mpMRI)examination,followed by transrectal ultrasound-guided prostate puncture.With puncture pathology as the gold standard,Logistic regression was used to analyze the PI-RADS v2 score combined with ADC value or classification,and the receiver operating characteristic(ROC)was used to compare the AUC of PI-RADS v2 score combined with ADC value or classification with the AUC of PI-RADS v2 score,ADC value or classification alone.Results:394 lesions were included,and 194 PCa lesions and 200 benign lesions were confirmed by puncture pathology.Logistic regression analysis showed that PI-RADS v2 score,ADC value or classification were independent predictors of PCa(all P<0.01).There was no significant difference in AUC value between PI-RADS v2 score+ADC value and PI-RADS v2 score+ADC classification(P>0.05),but both were all higher than that of PI-RADS v2 score alone(all P<0.05).The same is true for the peripheral zone and transition zone lesions(all P<0.05).The PI-RADS v2 score+ADC classification has the highest AUC value when the PI-RADS v2 score was 4.The pAUC of the PI-RADS v2 score+ADC classification was 3 times that of the PI-RADS v2 score alone.Conclusion:ADC can significantly improve the predictive performance of PI-RADS v2 score for PCa,especially for lesions with PI-RADS v2 score of 4.

关 键 词：第二版前列腺影像报告和数据系统 多参数磁共振成像 前列腺癌 表观扩散系数 前列腺穿刺 前列腺特异性抗原 

分 类 号：R737.25[医药卫生—肿瘤]