基于PI-RADS v2的双参数MRI改良评分方式对前列腺病变的诊断价值  

The value of modified biparametric MRI scoring method based on PI-RADS v2in the diagnosis of prostate lesions

作　　者：胡蓓蓓 张跃跃 杨硕[2] 檀双秀 沈钧康[2] 赵文露[2] HU Beibei;ZHANG Yueyue;YANG Shuo;TAN Shuangxiu;SHEN Junkang;ZHAO Wenlu(School of Medical Imaging,Jiangsu Vocational College of Medicine,Yancheng,Jiangsu Province 224001,China;Department of Radiology,the Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215004,China)

机构地区：[1]江苏医药职业学院医学影像学院,江苏盐城224001 [2]苏州大学第二附属医院影像科,江苏苏州215004

出　　处：《实用放射学杂志》2022年第3期450-453,共4页Journal of Practical Radiology

摘　　要：目的比较分析多参数磁共振成像(mp-MRI)和4种简化双参数磁共振成像(bp-MRI)评分方式对前列腺癌(PCa)的诊断效能.方法回顾性分析197例有病理诊断结果的前列腺病变患者的影像资料.运用Cohen’s Kappa检验评估2名医师采用5种评分方式(方式1为mp-MRI,方式2~5为bp-MRI)诊断结果间的一致性.运用受试者工作特征(ROC)曲线计算5种方式诊断PCa和临床显著性前列腺癌(csPCa)的诊断准确性,并加以比较.结果2名医师采用5种评分方式诊断结果间均有较好的一致性,其中方式2和方式1评分方式相当(k值为0.69)且高于方式3、4、5.诊断PCa的曲线下面积(AUC)值从大到小依次为:方式1(0.898)>方式2(0.889)>方式5(0.882)>方式4(0.875)>方式3(0.872),且方式2和方式1,方式5和方式1间诊断AUC值均无统计学差异(P>0.05).诊断csPCa的AUC值从大到小同样为:方式1(0.940)>方式2(0.928)>方式5(0.911)>方式4(0.908)>方式3(0.897),仅方式2和方式1间诊断AUC值无统计学差异(P>0.05).结论运用基于bp-MRI的评分方式(方式2)诊断PCa及csPCa的效能与mp-MRI基本相当,值得临床推广应用.Objective To compare and analyze the diagnostic efficacy of multi-parameter magnetic resonance imaging(mp-MRI)and four simplified biparametric magnetic resonance imaging(bp-MRI)scoring methods for prostate cancer(PCa).Methods The imaging data of 197 patients with prostate lesions and pathological diagnosis results were analyzed retrospectively.Cohen’s Kappa was introduced to test and evaluate the consistency in the diagnosis results of the two doctors who used 5 scoring modes(mode 1 was mp-MRI,mode 2-5 were bp-MRI).The receiver operating characteristic(ROC)curve was used to calculate and compare the diagnostic accuracy of 5 modes in the diagnostic PCa and clinically significant prostate cancer(csPCa).Results The diagnosis results of the two doctors who used 5 scoring modes presented good consistency.Among them,the scoring modes of mode 2 and mode 1 were equivalent(kvalue was 0.69),and higher than that of mode 3,4,and 5.The area under the curve(AUC)values for diagnostic PCa in descending order was:mode 1(0.898)>mode 2(0.889)>mode 5(0.882)>mode 4(0.875)>mode 3(0.872).Moreover,there was no statistically significant difference in the diagnostic AUC values between mode 2 and mode 1,mode 5 and mode 1(P>0.05).The AUC values for diagnostic csPCa in descending order was:mode 1(0.940)>mode 2(0.928)>mode 5(0.911)>mode 4(0.908)>mode 3(0.897).There was no statistically significant difference in the diagnostic AUC values between mode 2 and mode 1(P>0.05).Conclusion The efficiency of using bp-MRI based scoring method(mode 2)in the diagnosis of PCa and csPCa is basically equivalent to that of mp-MRI,which is worthy of clinical application.

关 键 词：前列腺癌 磁共振成像 前列腺影像报告和数据系统 

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