多参数MRI前列腺影像报告和数据系统评分与经直肠超声引导下穿刺病理的相关性分析

目的旨在探讨多参数MRI(multi-parametric MRI,Mp-MRI)前列腺影像报告和数据系统(prostate imaging reporting and data system version 2,PI-RADS V2)评分与经直肠超声引导下穿刺病理的相关性。材料与方法回顾性分析经病理证实的128例前列腺病变患者的MRI资料,其中前列腺癌75例,良性前列腺增生48例、前列腺炎5例,所有患者均行3.0 T MRI扫描,获取完整的T2WI、DWI及DCE图像;由2名前列腺诊断医师在不知患者临床资料及病理的情况下采用PIRADS V2评分标准进行评分,评分结果分别记录;所有患者均行经直肠超声引导下病理穿刺,并由泌尿专业病理诊断医师进行诊断,对前列腺癌则进行Gleason评分。采用Spearman相关分析PI-RADS V2评分与穿刺病理的相关系数,并采用ROC曲线分析PI-RADS V2评分诊断前列腺癌的敏感性、特异性和准确性。结果 PI-RADS V2评分与穿刺病理呈正相关,r=0.887。PI-RADS V2评分诊断前列腺癌的ROC曲线下面积0.975,其敏感性为93.33%,特异性为96.23%,准确性为94.51%,阳性预测值97.22%,阴性预测值91.07%。Gleason评分≥8分的前列腺癌的PI-RADS V2评分为5分。结论 PI-RADS V2评分与经直肠超声引导下穿刺病理的相关性高,PI-RADS V2评分对前列腺疾病的诊断准确性高。

The correlation between multi-parametric MRI of prostate imaging reporting and data system score and transrectal ultrasound guided needle biopsy

Objective: To explore the correlation between prostate imaging reporting and data system score version 2 (PI-RADS V2) on multi-parametric MRI and transrectal ultrasound (TRUS) guided prostate biopsy. Materials and Methods: A retrospective analysis of multi-parametric MRI (Mp-MRI) was performed in 128 patients with pathologically proven prostate diseases including prostate cancer (n=75), benign prostatic hyperplasia (n=48) and prostatitis (n=5). All the patients underwent 3.0 T Mp-MR imaging and subsequently TRUS guided prostate biopsy. Two readers independently assessed T2WI, DWI, DCE for each examination by using the PI-RADS V2 score, blinded to the indication for the MR imaging. The location of one specific lesion per case was denoted. Spearman correlation analysis was used to compare differences between PI-RADS V2 score and pathological findings. ROC curve analysis was performed to determine sensitivity, specificity and accuracy. Results: PI-RADS V2 score showed a significant positive correlation with needle biopsy (Spearman's coefficient 0.887, P<0.01). PI-RADS V2 had an accuracy of 94.51%, a PPV of 97.22%, and a NPV of 91.07%. Sensitivity was 93.33%, and specificity was 96.23%. Conclusion: The study demonstrates the value of PI-RADS V2 to improve detection and risk stratification in patients with suspected cancer in treatment of prostate glands diseases.