基于前列腺影像报告和数据系统评估T2WI联合分段读出弥散加权成像诊断早期前列腺癌的价值

目的比较分段读出平面回波成像(readout-segmented echo-planar imaging,RS-EPI)与单次激发平面回波成像(single-shot echo-planar imaging,SSEPI)在早期前列腺癌诊断中的价值。材料与方法回顾性纳入20例行3.0T MRI SS-EPI和RS-EPI检查的早期前列腺癌患者。两位影像科医生在不提供任何临床资料的情况下参照PI-RADS标准分析T2WI、RS-EPI和SS-EPI图像,按六分区法对前列腺各个分区出现癌的可能性进行评分。共组成5种方案:方案1:T2WI;方案2:SS-EPI;方案3:RS-EPI;方案4:T2WI+SS-EPI;方案5:T2WI+RSEPI。采用受试者工作特征(receiver operating characteristic,ROC)曲线比较5种方案的诊断效能。结果方案1~5的曲线下面积分别为0.789、0.790、0.874、0.838、0.881,由高到低的顺序为T2WI+RS-EPIRS-EPIT2WI+SS-EPISSEPIT2WI。方案1与方案3、方案4、方案5,方案2与方案3、方案4,方案4与方案5之间ROC曲线下面积差异有统计学意义(P0.05)。方案1与方案2,方案3与方案4、方案5之间ROC曲线下面积差异无统计学意义(P0.05)。结论 T2WI联合应用DWI可提高早期前列腺癌的诊断效能,T2WI联合RS-EPI的诊断效能高于T2WI联合SS-EPI,更利于临床早期前列腺癌的诊断。

Evaluation of T2WI and readout-segmented echo-planar imaging in diagnosing early prostate cancers:a study based on PI-RADS system

Objectives:To compare the clinical utility of readout-segmented echo-planar imaging (RS-EPI) with single-shot echo-planar imaging (SS-EPI) in diagnosing early prostatic cancers. Materials and Methods: Twenty surgically-proved early prostate cancer patients were collected in this retrospective study. T2WI, RS-EPI and SS-EPI were evaluated by two blinded radiologists. By using 6 sub-region classiifcation method the possibility of the presence of cancer at each sub-region was scored according to the PI-RADS system. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efifcacy of the following 6 protocols: T2WI alone (protocol 1), SS-EPI alone (protocol 2), RS-EPI (protocol 3), a combination of T2WI and SS-EPI (protocol 4) and a combination of T2WI and RS-EPI (protocol 5). Results:The area under the ROC curve (Az) of protocol 1 to protocol 5 for region-based analysis were 0.789, 0.790, 0.874, 0.838, 0.881, respectively. ROC analysis revealed signiifcant differences between protocol 1 and 3, 4, 5, and between protocol 2 and 3, 4, and between protocol 4 and 5 (P<0.05). While the difference between protocol 1 and 2, between 3 and 4, 5 has no statistical significance (P>0.05). Conclusions:The combination of T2WI and DWI can improve the diagnosis ability of early prostate cancers. Combination of T2WI and RS-EPI is a more effective approach than combination of T2WI and SS-EPI for the detection of early prostate cancers.