剪切波弹性成像联合多参数MRI对临床显著性前列腺癌的诊断价值  

Value of shear wave elastography combined with multi-parameter MRI in the diagnosis of clinically significant prostate cancer

作　　者：贾海云 王佳强[1] 周晓莹 常艺 王胜利[1] JIA Haiyun;WANG Jiaqiang;ZHOU Xiaoying;CHANG Yi;WANG Shengli(Department of Ultrasound,Yan’an University Affiliated Hospital,Shaanxi 716000,China)

机构地区：[1]延安大学附属医院超声医学科,陕西省延安市716000

出　　处：《临床超声医学杂志》2022年第8期603-607,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨剪切波弹性成像(SWE)联合多参数MRI(mpMRI)对临床显著性前列腺癌(csPCa)的诊断价值。方法选取我院泌尿外科疑诊为前列腺癌并行超声引导下前列腺穿刺活检的患者74例,根据穿刺活检病理结果将其分为csPCa组17例和非前列腺癌+临床不显著前列腺癌(cisPCa)组57例。比较两组临床指标、SWE参数和前列腺影像报告与数据系统(PI-RADS)评分。采用单因素及多因素Logistic逐步回归分析筛选csPCa的独立预测因子。绘制受试者工作特征(ROC)曲线分析并比较回归模型预测概率值与各独立预测因子的诊断效能。结果两组总前列腺特异抗原(tPSA)、游离前列腺特异抗原、前列腺特异抗原密度、前列腺体积(PV)、PI-RADS评分、杨氏模量最大值差值(Emax差)、杨氏模量平均值差值和杨氏模量最小值差值比较差异均有统计学意义(均P<0.05)。Logistic回归结果显示,tPSA、PV、Emax差及PI-RADS评分是csPCa的独立预测因子(OR=1.042、0.939、1.060、11.493);建立模型的回归方程:Y(P)=-2.213-0.063×PV+0.058×Emax差+2.442×PI-RADS评分+0.041×tPSA。ROC曲线分析显示,Logistic回归模型预测概率值预测csPCa的曲线下面积为0.954,敏感性为0.882,特异性为0.947;其曲线下面积均高于各独立预测因子。结论SWE联合mpMRI对csPCa有较高的诊断价值。Objective To explore the diagnostic value of shear wave elastography(SWE)combined with multiparameter MRI(mpMRI)in clinically significant prostate cancer(csPCa).Methods A total of 74 patients suspected of prostate cancer and underwent ultrasound-guided prostate biopsy in the department of urology of our hospital were selected.According to the pathological results of puncture biopsy,the patients were divided into csPCa group(n=17)and non-prostate cancer+clinically insignificant prostate cancer(cisPCa)group(n=57).The clinical parameters,SWE indexes and prostate imaging reporting and data system(PI-RADS)score were compared between the two groups.Univariate and multivariate Logistic stepwise regression analysis was used to screen the independent predictive factors of csPCa.Receiver operating characteristic(ROC)curve was drawn to analyze and compare the predictive probability value of the regression model with the diagnostic efficacy of each independent predictor.Results There were statistically significant differences in total prostate-specific antigen(tPSA),free prostate-specific antigen(fPSA),prostate-specific antigen density(PSAD),prostate volume(PV),PI-RADS score,maximum difference of Young’s modulus(Emax difference),mean difference of Young’s modulus and minimum difference of Young’s modulus between csPCa group and non-prostate cancer+cisPCa group(all P<0.05).The results of Logistic regression showed that tPSA,PV,Emax difference and PI-RADS score were independent predictors of csPCa(OR=1.042,0.939,1.060,11.493).The regression equation of the model was:Y(P)=-2.213-0.063×PV+0.058×Emax difference+2.442×PI-RADS score+0.041×tPSA.ROC curve analysis showed that the area under curve of Logistic regression model in predicting csPCa was 0.954,sensitivity was 0.882,and specificity was 0.947,and the area under the curve was higher than that of each independent predictor.Conclusion SWE combined with mpMRI has high diagnostic value for csPCa.

关 键 词：剪切波弹性成像 MRI 前列腺影像报告与数据系统 前列腺癌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]