多参数磁共振PI-RADS评分系统在疑似前列腺癌患者中的诊断价值

张强; 蔡宇坤; 张晓卿; 李学松; 周利群

doi:10.13201/j.issn.1001-1420.2020.03.001

多参数磁共振PI-RADS评分系统在疑似前列腺癌患者中的诊断价值

- 北京大学第一医院泌尿外科北京大学泌尿外科研究所国家泌尿男生殖系肿瘤研究中心(北京, 100034)

详细信息

通讯作者: 周利群,E-mail:zhoulq@sina.com

中图分类号: R737.25

收稿日期: 2019-06-02

Diagnostic value of multiparametric MRI using PI-RADS in patients with suspected prostate cancer

- Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing, 100034, China

More Information

Corresponding author: ZHOU Liqun, E-mail: zhoulq@sina.com

Received Date: 02 June 2019

摘要

摘要: 目的:评估多参数磁共振PI-RADS评分系统对疑似前列腺癌患者临床诊断决策的影响。方法:选取疑似前列腺癌并初次行前列腺多参数MRI检查的患者989例为研究对象,收集其行MRI检查时的前列腺特异性抗原(PSA)值,检查原因及前列腺穿刺等相关资料与数据,并对多参数MRI结果进行PI-RADSV2评分,运用SPSS 18.0统计软件对不同PSA水平患者的前列腺MRI(PI-RADSV2)诊断效能及指导价值进行统计学比较。结果:PSA升高仍是目前泌尿外科医生建议患者行多参数MRI检查的主要原因,占多参数MRI检查总数的86.05%;而当患者总前列腺特异性抗原(TPSA) 4~<20 ng/mL时,泌尿外科医生最需要依赖患者多参数MRI(PI-RADS)结果决定是否进行前列腺穿刺,占多参数MRI检查时TPSA分布的72.62%;在不同TPSA分层中,PI-RADS结果分布存在高度统计学差异(P<0.001)。MRI检查结果为阴性(PI-RADS 1~2分)时,TPSA 4~<20 ng/mL组穿刺率与TPSA≥20 ng/mL组比较差异有统计学意义(P=0.005);MRI检查结果为阳性(PI-RADS 3~5分)时,TPSA 4~<20 ng/mL组的穿刺阳性率与TPSA≥20 ng/mL组比较差异有统计学意义(P<0.001)。结论:多参数磁共振PI-RADS评分系统结果影响着泌尿外科医生对于TPSA升高患者的诊疗决策;PI-RADSV2对TPSA 4~<20 ng/mL的诊断效能与总体无差异,可提高TPSA 4~<20 ng/mL患者的穿刺阳性率。
- 多参数磁共振成像 /
- PI-RADS /
- 诊断 /
- 前列腺癌
Abstract: Objective: To evaluate the impact of multiparametric magnetic resonance imaging(mp-MRI) using prostate imaging reporting and data system V2(PI-RADSV2) on the diagnostic decision in patients with suspected prostate cancer. Method: A retrospective analysis was conducted in 989 patients who underwent prostate mp-MRI in order to exclude prostate cancer at a single center from January 2018 to December 2018. The findings on mp-MRI was assessed using PI-RADS version2. The PSA values, reason for inspection and data of prostate biopsy were collected. Diagnostic efficiency and practiced value of mp-MRI using PI-RADSV2 were evaluated in different PSA levels by SPSS 18.0. Result: The elevated PSA level was main reason why the urologist recommended the patients to undergo mp-MRI, which accounted for 86.05%. When the TPSA level was 4-<20 ng/mL, which accounted for 72.62%, the urologists mostly depended on mp-MRI to make a decision whether the prostate biopsy was necessary. There was significant difference between the distribution of PI-RADS and TPSA levels(P<0.001). The biopsy rate showed statistically significance between TPSA 4-<20 ng/mL group and TPSA≥20 ng/mL group(P=0.005) in the negative result of PI-RADS(1-2). Statistically significance of positive rate of prostate biopsy was observed between TPSA 4-<20 ng/mL group and TPSA≥20 ng/mL group(P<0.001) in the positive result of PI-RADS(3-5).Conclusion: Mp-MRI using PI-RADSV2 may affect the urologists' decision in patients with elevated PSA level. No difference of diagnostic efficiency was found between any TPSA level and the TPSA level from 4 to 20 ng/mL. Mp-MRI using PI-RADS could improve the prostate cancer detection rate in PSA 4-<20 ng/mL.
- multiparametric MRI /
- PI-RADS /
- diagnosis /
- prostate cancer

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