3.0T磁共振成像技术在前列腺癌临床病理特征评估中的价值研究  

Value of 3.0T MRI technique in assessing clinically pathologic features of prostate cancer

作　　者：吴磊 朱晶洁 仝贺 李松 谷明利 Wu Lei;Zhu Jingjie;Tong He;Li Song;Gu Mingli(Department of Radiology,The Second Affiliated Hospital of Bengbu Medical University,Bengbu 233000,China;Department of Endocrinology,The Second Affiliated Hospital of Bengbu Medical University,Bengbu 233000,China;Department of Urology,The Second Affiliated Hospital of Bengbu Medical University,Bengbu 233000,China)

机构地区：[1]蚌埠医科大学第二附属医院放射科,蚌埠233000 [2]蚌埠医科大学第二附属医院内分泌科,蚌埠233000 [3]蚌埠医科大学第二附属医院泌尿外科,蚌埠233000

出　　处：《中国医学装备》2025年第3期48-52,共5页China Medical Equipment

基　　金：安徽省教育厅重大项目基金(2023AH040284)

摘　　要：目的:探讨3.0T磁共振成像(MRI)技术在前列腺癌(PCa)临床病理特征评估中的价值。方法:回顾性分析2020年4月至2024年7月在蚌埠医科大学第二附属医院行MRI并经组织病理学认证的102例前列腺疾病患者病例资料,将其中51例PCa患者纳入癌症组,51例前列腺增生患者纳入增生组。所有患者均完成多参数磁共振成像,采用前列腺MRI报告和数据系统第2版(PI-RADS v2.1)对影像学表现进行评分,比较分析两组间的评分分布。采用Spearman相关分析探究PI-RADS v2.1评分与PCa的Gleason评分、血清前列腺特异性抗原(PSA)水平、肿瘤分期和侵袭性等临床病理特征的相关性。采用受试者工作特征(ROC)曲线分析3.0T磁共振成像技术对PCa的诊断效能。结果:癌症组患者PI-RADS v2.1评分4(4,5)分,显著高于增生组患者的2(3,4)分,两组比较差异有统计学意义(U=369.5,P<0.01),而评分分布上癌症组高分(4,5分)占比较增生组更多,两组比较差异有统计学意义(x^(2)=51.220,P<0.05)。癌症组患者PI-RADSv2.1评分与血清PSA水平、Gleason评分以及肿瘤分期和侵袭性表现出显著相关性(r=0.815、0.723、0.693,P<0.05)。ROC曲线分析显示,PI-RADS v2.1评分诊断PCa的曲线下面积为0.858(95%CI:0.783~0.932),能够有效区分PCa和前列腺增生,具有较高的诊断效能且高于PSA。结论:3.0T MRI技术对PCa的诊断有良好的准确性,可作为无创性检查手段来诊断并评估肿瘤病理特征。Objective:To investigate the value of 3.0T magnetic resonance imaging(MRI)in the assessment for clinically pathologic features of prostate cancer(PCa).Methods:The case data of 102 PCa patients who were confirmed by histology in The Second Affiliated Hospital of Bengbu Medical University from April 2020 to July 2024 were retrospectively analyzed.51 PCa patients of them were included in cancer group,and 51 patients with prostatic hyperplasia were included in hyperplasia group.Multi-parametric MRI was implemented in all patients.Imaging performance was scored by using Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1).The distribution of scores between the two groups was compared and analyzed.The correlations between the PI-RADS v2.1 scores and PCa clinically pathological features which included Gleason scores,serum prostate specific antigen(PSA)level,tumor staging and aggressiveness were analyzed and explored by using Spearman correlation analysis.The diagnostic efficacy of the 3.0T MRI technique for PCa was analyzed by using the receiver operating characteristic(ROC)curve.Results:The PI-RADS v2.1 score of cancer group was 4(4,5)scores,which was significantly higher than 2(3,4)scores of hyperplasia group,and the difference of that between two groups was significant(U=369.5,P<0.05).The rate of high scores(4,5 scores)of cancer group was more than that of hyperplasia group in the distribution of scores,and the difference of that between two groups was significant(x^(2)=51.220,P<0.05).In patients of cancer group,PI-RADS v2.1 score showed significant correlation with serum PSA level,Gleason score,tumor staging and aggressiveness(P<0.05),respectively,and they were significant(r=0.815,0.723,0.693,P<0.05).ROC curve analysis showed that the area under curve(AUC)value of PI-RADS v2.1 score was 0.858(95%CI:0.783-0.932)in diagnosing PCa,which can effectively distinguish PCa and prostate hyperplasia.It had higher diagnostic efficacy,which was higher than that of serum PSA.Conclusions:3.0T MRI has favorable acc

关 键 词：前列腺癌(PCa) 前列腺增生 磁共振成像(MRI) Gleason分级评分 前列腺成像报告和数据系统第2版(PI-RADSv2.1) 

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]