超微血管成像技术与多参数磁共振检查在前列腺癌诊断中的应用价值比较  

Comparison of the application value of superb microvascular imaging and multiparameter magnetic resonance in the diagnosis of prostate cancer

作　　者：何竹[1] 张渊[1] 单君[1] 傅宇 江泉[1] HE Zhu;ZHANG Yuan;SHAN Jun;FU Yu;JIANG Quan(Department of Ultrasound,Shanghai Pudong New Area People's Hospital,Shanghai 201299,China)

机构地区：[1]上海市浦东新区人民医院超声科,上海201299

出　　处：《影像研究与医学应用》2024年第12期7-11,共5页Journal of Imaging Research and Medical Applications

基　　金：上海市浦东新区卫生健康委员会卫生计生科研项目(PW2021A-34)。

摘　　要：目的:比较超微血管成像(SMI)技术与多参数磁共振(mpMRI)检查对前列腺癌的诊断准确性。方法:选取2022年1月—2023年11月上海市浦东新区人民医院收治的61例可疑前列腺癌患者,均行SMI和mpMRI检查以及经直肠超声(TRUS)引导的系统穿刺+可疑病灶的靶向穿刺活检术,以病理结果为金标准,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),评估SMI、mpMRI及SMI联合mpMRI诊断前列腺癌的准确率。结果:61例疑似前列腺癌患者中,病理诊断为前列腺腺癌22例,良性39例。SMI检出23例有异常征象,其中17例病理诊断为恶性,SMI诊断前列腺癌的灵敏度为77.27%、特异度84.62%、阳性预测值73.91%、阴性预测值86.84%、准确率81.97%。mpMRI检出24例有异常征象,其中20例病理诊断为恶性,mpMRI诊断前列腺癌的灵敏度为90.91%、特异度为89.74%、阳性预测值83.33%、阴性预测值94.59%、准确率90.16%。SMI联合mpMRI诊断前列腺癌的灵敏度为95.45%、特异度为79.49%、阳性预测值72.41%、阴性预测值96.88%、准确率85.25%。ROC曲线分析结果显示,SMI、mpMRI及SMI联合mpMRI诊断前列腺癌的AUC分别为0.809(95%CI:0.688~0.931)、0.903(95%CI:0.814~0.993)及0.875(95%CI:0.782~0.968),3种诊断方法比较差异无统计学意义(SMI vs mpMRI,Z=-1.591、P=0.112,SMI vs SMI联合mpMRI,Z=-1.427、P=0.153,mpMRI vs SMI联合mpMRI,Z=0.852、P=0.394)。结论:mpMRI诊断前列腺癌的准确率高于SMI,两者联合应用并精准靶向穿刺可提高前列腺癌的检出率。Objective To compare the diagnostic accuracy of superb microvascular imaging(SMI)technology and multi-parameter magnetic resonance imaging(mpMRI)in prostate cancer.Methods 61 suspected prostate cancer patients admitted to the Shanghai Pudong New Area People's Hospital from January 2022 to November 2023 were selected to undergo SMI and mpMRI,as well as systematic puncture guided by transrectal ultrasound(TRUS)and targeted puncture biopsy of suspected lesions.With pathological results as the gold standard,the receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to evaluate the accuracy of SMI,mpMRI and SMI combined with mpMRI in diagnosis of prostate cancer.Results Among 61 suspected prostate cancer patients,22 cases were pathologically diagnosed as prostate adenocarcinoma and 39 cases were benign.SMI detected abnormal signs in 23 cases,of which 17 cases were malignant.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of SMI for prostate cancer was 77.27%,84.62%,73.91%,86.84%,81.97%.mpMRI detected 24 cases with abnormal signs,of which 20 cases were pathologically diagnosed as malignant.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of mpMRI for prostate cancer was 90.91%,89.74%,83.33%,94.59%,90.16%.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of SMI combined with mpMRI for prostate cancer was 95.45%,79.49%,72.41%,96.88%,85.25%.ROC curve analysis results showed that,the AUC of SMI,mpMRI and SMI combined with mpMRI in diagnosis of prostate cancer was 0.809(95%CI:0.688-0.931),0.903(95%CI:0.814-0.993)and 0.875(95%CI:0.782-0.968),respectively.There was no significant difference between the three diagnostic methods(SMI vs mpMRI,Z=-1.591,P=0.112,SMI vs SMI combined with mpMRI,Z=-1.427,P=0.153,mpMRI vs SMI combined with mpMRI,Z=0.852,P=0.394).Conclusion The accuracy of mpMRI in the diagnosis of prostate ca

关 键 词：前列腺癌 超微血管成像 多参数磁共振 经直肠超声 靶向穿刺 

分 类 号：R445.2[医药卫生—影像医学与核医学]