首页|PI-RADS v2.1对外周带、移行带及多区域前列腺临床显著癌的诊断性能研究

PI-RADS v2.1对外周带、移行带及多区域前列腺临床显著癌的诊断性能研究

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目的:评估前列腺影像报告和数据系统v2.1(PI-RADS v2.1)对外周带(PZ)、移行带(TZ)及多区域(MZ)的前列腺临床显著癌(CSPCa)的诊断性能.方法:回顾性研究2021年1月至2023年1月108例在我院行前列腺多参数磁共振成像(mpMRI)并行经会阴前列腺穿刺活检的临床资料,并采用PI-RADS v2.1对疑似前列腺癌(PCa)患者的MR图像进行评估和诊断,以前列腺穿刺活检的病理结果为诊断金标准并与PI-RADS v2.1诊断结果进行对照,评估PI-RADS v2.1与CSPCa的相关性.采用受试者工作特征曲线(ROC)计算曲线下面积(AUC),描述PI-RADS v2.1对PZ、TZ及MZ的CSPCa的诊断性能.结果:所有患者均顺利完成经会阴前列腺穿刺,CSPCa(GS=7~10)者66例,占61.11%.47例PZ病变中,可疑CSPCa者45例,占95.74%;17例TZ病变中,可疑CSPCa 者 8 例,占 47.06%;44 例 MZ 病变中,可疑 CSPCa 者 40 例,占 90.91%;PI-RADS v2.1 对 PZ、TZ 及 MZ 病变部位诊断均与CSPCa存在显著相关性(r=0.492,P<0.001).PI-RADS v2.1对PZ、TZ及MZ部位AUC分别为0.644、0.732及0.811;灵敏度分别为66.8%、57.6%及62.1%;灵敏度分别为57.2%、78.4%及93.2%.阴性预测值分别为46.5%、85.7%及79.2%;阳性预测值分别为76.2%、43.4%及84.8%.结论:PI-RADS v2.1评分对PZ、TZ及MZ部位CSPCa均有较好的诊断效能,其中对于MZ的诊断效能最佳.
Diagnostic performance of PI-RADS v2.1 for clinically significant prostate cancer in the peripheral,transitional and multiple zones
Objective:To evaluate the diagnostic performance of the Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1)for clinically significant prostate cancer(CSPCa)in the peripheral zone(PZ),transitional zone(TZ)and multiple zones(MZs).Methods:We retrospectively studied the clinical data on 108 patients undergoing multiparametric magnetic resonance imaging(mpMRI)and transperineal prostate biopsy in our hospital from January 2021 to January 2023.Using PI-RADS v2.1,we ex-amined the MR images of the patients with suspected PCa,compared the PI-RADS v2.1 scores with the results of prostate biopsy,and analyzed the correlation of the PI-RADS v2.1 scores with CSPCa.We calculated the area under the receiver operating characteristic(ROC)curve(AUC),and described the diagnostic performance of PI-RADS v2.1 for CSPCa in the PZ,TZ and MZs.Results:Transperineal prostate puncture biopsy was successfully completed in all the patients,which revealed 66(61.11%)cases of CSPCa with Gleason score(GS)7-10.Suspected CSPCa was observed in 45(95.74%)of the 47 PZ lesions,8(47.06%)of the 17 TZ le-sions,and 40(90.91%)of the 44 MZ lesions.The PZ,TZ and MZ lesions diagnosed by PI-RADS v2.1 were significantly correlated with CSPCa(r=0.492,P<0.001).The AUCs of PI-RADS v2.1 for PZ,TZ and MZs were 0.644,0.732 and 0.811,with specificities of 66.8%,57.6%and 62.1%,and sensitivities of 57.2%,78.4%and 93.2%,respectively.The negative predictive values were 46.5%,85.7%and 79.2%,and the positive predictive values 76.2%,43.4%and 84.8%,respectively.Conclusion:The PI-RADS v2.1 score has a high diagnostic value for CSPCa in the PZ,TZ and MZs,with the best performance for that in the MZs.

prostate cancerProstate Imaging Reporting and Data System version 2.1prostate biopsymultiparametric mag-netic resonance imaging

邓晓俊、张皓诚、张炯、钱宇航、陶玫玫、廖春梅、林妙文、郎根强

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上海大学附属四一一医院泌尿外科,上海 200081

上海大学附属四一一医院护理部,上海 200081

前列腺癌 前列腺影像报告和数据系统v2.1 前列腺穿刺活检 前列腺多参数磁共振成像

2024

中华男科学杂志
南京军区南京总医院

中华男科学杂志

CSTPCD
影响因子:1.052
ISSN:1009-3591
年,卷(期):2024.30(11)