第2版和第2.1版前列腺影像报告与数据系统对前列腺移行带病变的诊断价值比较  

Comparison of the diagnostic value between PI-RADS score version 2 and version 2.1 for prostate transitional zone lesions

作　　者：李志平 张永胜[1] 崔凤[1] 徐辉景 余克勤 LI Zhiping;ZHANG Yongsheng;CUI Feng;XU Huijing;YU Keqin(Department of Radiology,Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310007,China)

机构地区：[1]浙江中医药大学附属杭州市中医院放射科,310007 [2]浙江中医药大学附属杭州市中医院泌尿外科,310007

出　　处：《浙江医学》2022年第11期1169-1173,1211,共6页Zhejiang Medical Journal

基　　金：浙江省卫生健康科技计划项目(2022KY996);浙江省医药卫生科技计划项目(2020KY227);浙江省中医药科技计划项目(2022ZA102);浙江中医药大学校级科研项目(2021JKJNTZ020A)。

摘　　要：目的比较分析第2版和第2.1版前列腺影像数据与报告系统(PI-RADS V2、V2.1)对前列腺移行带病变评分的一致性及诊断效能。方法回顾2018年12月至2020年12月浙江中医药大学附属杭州市中医院经手术病理检查证实为移行带前列腺癌(PCa)和良性前列腺增生(BPH)的患者135例。由2位放射科医师(主治医师、副主任医师各1位)分别采用PI-RADS V2、V2.1对入组患者进行诊断评分。采用加权Kappa检验评估2位医师评分的一致性,采用ROC曲线评估两种评分标准对PCa、临床显著性前列腺癌(csPCa)的诊断效能。结果2位医师采用PI-RADS V2和V2.1在BPH、PCa、csPCa、BPH+PCa的加权Kappa值分别为0.500、0.867、0.818、0.654和0.688、0.870、0.871、0.790。PI-RADS V2.1的一致性高于PI-RADS V2。医师1和医师2采用PI-RADS V2、V2.1诊断PCa的AUC分别为0.749、0.879和0.858、0.898,诊断csPCa的AUC分别为0.877、0.921和0.929、0.936。PI-RADS V2.1诊断PCa、csPCa的AUC均高于PI-RADS V2。结论PI-RADS V2.1对前列腺移行带病变评分的一致性高于PI-RADS V2,对PCa的诊断效能稍高于PI-RADS V2。Objective To compare diagnostic efficiency between prostate imaging reporting and data system version 2 and version 2.1(PI-RADS V2 and V2.1)for prostate transitional zone lesions.Methods Clinical and pathological data of 135 patients with transitional zone prostate cancer(PCa)or benign prostatic hyperplasia(BPH)confirmed by surgical pathology in Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University from December 2018 to December 2020 were retrospectively analyzed.Two radiologists independently used PI-RADS V2 and V2.1 respectively to perform diagnostic scores on the enrolled cases.The weighted Kappa test was used to evaluate the consistency of the two radiologists,the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of the two scoring criteria for PCa and clinical significant prostate cancer(csPCa).Results The weighted Kappa values between the scores of BPH,PCa,csPCa,BPH+PCa by the two radiologists using PI-RADS V2 and V2.1 were 0.500,0.867,0.818,0.654 and 0.688,0.870,0.871,0.790,respectively.PI-RADS V2.1 had a better consistency than PI-RADS V2.Area under the ROC curve(AUC)of PCa diagnosed by two radiologists using PI-RADS V2 and V2.1 scores were 0.749,0.879 and 0.858,0.898,respectively,and the AUC of csPCa were 0.877,0.921 and 0.929,0.936,respectively.The AUC of PI-RADS V2.1 in diagnosing PCa and csPCa was higher than those of PI-RADS V2.Conclusion The consistency of PI-RADS V2.1 in transitional zone lesions was better than PI-RADS V2, and the diagnostic efficiency of PI-RADS V2.1 for transitional prostate carcinoma was slightly higher than that of PI-RADS V2.

关 键 词：前列腺癌 磁共振成像 前列腺影像报告和数据系统 比较研究 

分 类 号：R737.25[医药卫生—肿瘤]