双参数与多参数磁共振对前列腺癌检出率的对比分析  

Comparison of biparametric and multiparametric MRI on prostate cancer detection rate

作　　者：潘永昇 曹栋梁 季陈 陈建刚[1] 郑兵[1] 顾栋华[1] Pan Yongsheng;Cao Dongliang;Ji Chen;Chen Jiangang;Zheng Bing;Gu Donghua(Department of Urology,the Second Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学第二附属医院泌尿外科,南通226001

出　　处：《国际泌尿系统杂志》2022年第6期981-986,共6页International Journal of Urology and Nephrology

基　　金：江苏省干部保健科研项目(BJ21010);南通市卫生健康委员会科研课题(QA2020010);南通市基础研究和民生科技计划指导性课题(JCZ21079)。

摘　　要：目的比较双参数磁共振(bpMRI)与多参数磁共振(mpMRI)对前列腺癌(PCa)及有临床意义前列腺癌(csPCa)的检出率差异。方法回顾性分析2018年1月至2021年3月于本院行前列腺穿刺活检的402例患者的临床资料。分析患者的基线资料对活检阳性率的影响。根据活检前的MRI检查结果,将患者分为bpMRI组(165例)与mpMRI组(237例),比较两组PCa及csPCa的检出率。对两组患者的总前列腺特异性抗原(tPSA)、前列腺体积(PV)和第2版前列腺影像报告和数据系统(PI-RADS V2)评分进行分层分析,比较不同tPSA区间、不同PV及不同PI-RADS V2评分时,两组患者对PCa及csPCa的检出率差异。结果患者年龄越大,PCa阳性率越高(P<0.001);随着tPSA水平的升高,PCa阳性率越高(P<0.001);随着PV的增大,PCa阳性率反而降低(P<0.001);患者PI-RADS V2评分越高,PCa阳性率越高(P<0.001)。两组的PCa及csPCa检出率比较,差异均无统计学意义(均P>0.05)。在tPSA 10~20 ng/mL区间内,mpMRI组的PCa检出率及csPCa检出率高于bpMRI组(58.1%vs.31.7%,P=0.004;46.8%vs.20.6%,P=0.002),差异均有统计学意义(均P<0.05);在其他tPSA区间(tPSA<4 ng/mL、4~10 ng/mL,20~100 ng/mL)、不同PV(≤30 mL、30~60 mL、>60 mL)及不同PI-RADS V2评分(3、4、5分)时,两组的PCa和csPCa检出率比较,差异均无统计学意义(均P>0.05)。结论bpMRI与mpMRI对PCa及csPCa的检出率相当,但是,在tPSA 10~20 ng/mL区间内,mpMRI对PCa及csPCa的检出率高于bpMRI。Objective To compare the detection rates of prostate cancer(PCa)and clinically significant prostate cancer(csPCa)between biparameter magnebic resonance imaging(bpMRI)and multi-parameter magnetic resonance imaging(mpMRI).MethodsThe clinical data of 402 patients who underwent prostate biopsy in the department of urology,the second affiliated hospital of Nantong university from January 2018 to March 2021 were retrospectively analyzed.The effect of baseline data on the positive rate of biopsy was analyzed.According to the results of MRI examination before biopsy,the patients were divided into bpMRI group and mpMRI group,and the detection rates of PCa and csPCa were compared between the two groups.Stratified analysis of total prostate specific antigen(tPSA),prostate volume(PV)and prostate Imaging Reporting and Data System Version 2(PI-RADS V2)scores were performed between the two groups.The detection rates of PCa and csPCa were different between the two groups.Results The older the patient was,the higher the detection rate of prostate cancer was(P<0.001).The positive rate of prostate biopsy was higher with the increase of tPSA level(P<0.001),but decreased with the increase of PV(P<0.001).The higher the PI-RADS V2 score was,the higher the positive rate of prostate biopsy was(P<0.001).The detection rate of PCa and csPCa was similar between bpMRI group and mpMRI group,with no statistical significance(P>0.05).But when tPSA level ranged from 10 to 20 ng/mL,mpMRI group had higher detection rates of PCa(58.1%vs..31.7%,P=0.004)and csPCa(46.8%vs.20.6%,P=0.002)than bpMRI group,and the dfference was statistically significant.However,in other tPSA level intervals(tPSA<4 ng/mL,4-10 ng/mL,20-100 ng/mL),PV intervals(≤30 mL,30-60mL,>60mL)and different PI-RADS V2 scores(3,4,5 points),the detection rates of PCa and csPCa were similar,with nostatistical significance(all P>0.05).ConclusionsThe detection rates of PCa and csPCa were similar between bpMRI group and mpMRI group,but when tPSA level ranged from 10-20 ng/mL,the detection rate

关 键 词：前列腺肿瘤 磁共振成像 多参数磁共振成像 前列腺特异抗原 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]