PI-RADS v2.1联合ADC值对前列腺移行带癌的诊断效能评估  

Evaluation of the Diagnostic Performance of PI-RADS v2.1 Combined with ADC Value in Prostate Transitional Zone Cancer

作　　者：林俊坤 钟治平 陈志远 尚晓静 胡应锋 LIN Junkun;ZHONG Zhiping;CHEN Zhiyuan;SHANG Xiaojing;HU Yingfeng(Department of Radiology,The Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510000,China)

机构地区：[1]广州中医药大学第二附属医院放射科,广州510000

出　　处：《中国医学计算机成像杂志》2022年第5期510-516,共7页Chinese Computed Medical Imaging

摘　　要：目的:评估前列腺影像报告和数据系统第2.1版(PI-RADS v2.1)联合表观弥散系数(ADC)对前列腺移行带癌(TZ-PCa)的诊断价值。方法:回顾性收集经病理证实的257例前列腺移行带病变患者的MRI影像资料,其中TZ-PCa患者121例,良性前列腺增生(BPH)患者136例。由2名影像科医师在未知病理结果情况下根据PI-RADS v2.1标准分别对病灶进行评分,并测量病灶的ADC值。首先评估2名医师间的诊断一致性强度,并分别建立PI-RADS v2.1、PI-RADS v2.1联合ADC值(连续变量)、PI-RADS v2.1联合ADC值(分类变量)诊断TZ-PCa的logistic回归模型,绘制受试者工作特征(ROC)曲线并分析各模型对TZ-PCa的诊断效能,比较其诊断差异。结果:2名医师的诊断具有良好的一致性强度。其中,PI-RADS v2.1联合ADC值(连续变量、分类变量)诊断TZ-PCa的灵敏度、特异度分别为0.88、0.82及0.80、0.91,均高于单独使用PI-RADS v2.1的0.83、0.78,且各诊断模型ROC曲线下面积(AUC)间差异具有统计学意义(P<0.05),尤其对于PI-RADS评分2~3分的病变,联合ADC值(连续变量、分类变量)诊断TZ-PCa的灵敏度、特异度分别为0.74、0.82及0.69、0.76,明显高于单独使用PI-RADS v2.1的0.59、0.74。结论:PI-RADS v2.1联合ADC值对TZ-PCa的诊断效能优于单独使用PI-RADS v2.1,且对于PI-RADS评分2~3分的病变,引入ADC值能帮助提高TZ-PCa的诊断准确率。Purpose:To evaluate the diagnostic value of Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1)combined with apparent diffusion coefficient(ADC)in prostate transitional zone cancer(TZ-PCa).Methods:The MRI images of 257 patients with pathologically confirmed prostate transitional zone disease were retrospectively collected,including 121 cases of TZ-PCa and 136 cases of benign prostatic hyperplasia(BPH).The score of prostate lesions in TZ and their ADC value were measured by two radiologists blindly.Diagnostic agreement was assessed between them,and logistic regression models were established to diagnose TZ-PCa.For models:PIRADS v2.1,PI-RADS v2.1 combined with ADC value(continuous variable),PI-RADS v2.1 combined with ADC value(classified variable)were established,and the receiver operator characteristic(ROC)curve were drawn to analyze the diagnostic efficacy of different models for TZ-PCa and compare their diagnostic efficacy.Results:The sensitivity and specificity of PI-RADS v2.1 combined with ADC values(continuous variable and classified variable)in the diagnosis of TZ-PCa were 0.88 and 0.82,0.80 and 0.91 respectively,which were higher than those of PI-RADS v2.1 alone(0.83 and 0.78),the difference of AUC between them was with statistical significance(P<0.05).Especially for lesions with PI-RADS score of 2 and 3,the sensitivity and specificity of combined with ADC values(continuous variable and classified variable)in diagnosing TZ-PCa were 0.74 and 0.82,0.69 and 0.76,respectively,which were higher than those of PI-RADS v2.1 alone(0.59 and 0.74).Conclusion:The diagnostic efficiency of PIRADS v2.1 combined with ADC value for TZ-PCa is better than that of PI-RADS v2.1 alone,and especially in this study,for lesions with PI-RADS score of 2 and 3,the ADC value can help to improve the diagnostic capability of TZPCa.

关 键 词：前列腺影像报告和数据系统第2.1版 前列腺移行带癌 表观弥散系数 效能评估 

分 类 号：R445.2[医药卫生—影像医学与核医学]