前列腺影像报告和数据系统v2和v2.1检测移行区临床显著前列腺癌的比较  

Comparison of prostate imaging reporting and data system v2 and v2.1 for the detection of transition zone clinically significant prostate cancer

作　　者：卢娴[1] 陈建新[1] 胡翼江[1] 蔡惠芳[1] 徐正道[1] 顾佳宇 沈丽萍 张同华[1] LU Xian;CHEN Jianxin;HU Yijiang;CAI Huifang;XU Zhengdao;GU Jiayu;SHEN Liping;ZHANG Tonghua(Imaging Center,Zhangjiagang First People’s Hospital,Suzhou,Jiangsu Province 215600,China)

机构地区：[1]张家港市第一人民医院影像中心,江苏苏州215600

出　　处：《实用放射学杂志》2022年第12期2027-2030,共4页Journal of Practical Radiology

摘　　要：目的比较前列腺影像报告和数据系统(PI-RADS)v2与v2.1检出移行区临床显著前列腺癌(TZ cs-PCa)的诊断效能。方法150例前列腺特异性抗原(PSA)水平升高的患者行3.0T多参数磁共振成像(mpMRI)检查,包括T2WI和扩散加权成像(DWI),以经直肠超声引导下前列腺组织活检病理作为参照标准。2名医师使用PI-RADS v2和v2.1分别给每个移行区(TZ)病灶评分。根据诊断敏感性、特异性和曲线下面积(AUC)比较这2种方法的诊断效能。结果在121例患者中,74例诊断为TZ cs-PCa[格林森评分(GS)=3+3,n=6;GS=3+4,n=19;GS=4+3,n=15;GS=4+4,n=12;GS=4+5,n=12;GS=5+4,n=9;GS=5+5,n=1]和47例良性病变。2个版本之间的诊断准确性无差异(P≥0.05),v2.1的诊断敏感性更高,但特异性低于v2,v2.1的AUC高于v2,但差异并不显著(0.938 vs 0.932,P=0.707)。结论与PI-RADS v2相比,PI-RADS v2.1评估TZ病变可能更适合,但其特异性较低,会导致过度活检。Objective To compare the diagnostic performance between prostate imaging reporting and data system(PI-RADS)v2.1 and v2 in detecting transition zone clinically significant prostate cancer(TZ cs-PCa).Methods A total of 150 patients with elevated prostate-specific antigen(PSA)underwent multiparameter magnetic resonance imaging(mpMRI)scan on 3.0T.Sequences included T2WI and diffusion weighted imaging(DWI).The standard of reference was transrectal ultrasonography guided prostate biopsy.Transition zone(TZ)lesions were scored by two readers using PI-RADS v2 and v2.1.The diagnostic performance of the two methods was compared in terms of diagnostic sensitivity,diagnostic specificity,and area under the curve(AUC).Results Of the 121 patients,74 were diagnosed with TZ cs-PCa[Gleason score(GS)=3+3,n=6;GS=3+4,n=19;GS=4+3,n=15;GS=4+4,n=12;GS=4+5,n=12;GS=5+4,n=9;GS=5+5,n=1]and 47 with benign lesions.There were no difference in diagnostic accuracy between the two versions(P≥0.05),the diagnostic sensitivity of v2.1 was higher,but the specificity was higher in v2.AUC tended to be higher in v2.1 than v2,but the difference was not significant(0.938 vs 0.932,P=0.707).Conclusion Compared with PI-RADS v2,PI-RADS v2.1 could be more practicable in evaluating TZ lesions,but it might result in excessive biopsies because of lower specificity.

关 键 词：前列腺癌 前列腺影像报告和数据系统 磁共振成像 

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