摘要
目的探讨第二版前列腺影像报告和数据系统(PI-RADSv2)对前列腺移行带病变的诊断价值。方法收集经病理证实的135例前列腺移行带病变的临床和多参数MRI资料。由两位医师采用PI-RADSv2对前列腺移行带病变进行评分,应用Cohen’s Kappa检验对评分结果进行一致性分析。计算移行带癌和非癌病变的平均PI-RADSv2评分,应用独立样本t检验比较两者间的差异性;运用ROC曲线评价PI-RADSv2对移行带临床显著癌的诊断效能。结果两位医师采用PI-RADSv2对移行带癌、临床显著癌、非临床显著癌(Gleason3+3)和非癌病变诊断评分的一致性,Kappa值分别为0.738、0.807、0.719和0.708。移行带癌、非癌病变的平均PI-RADSv2评分分别为4.38±0.88、2.83±0.84,差异具有统计学意义(P<0.05)。PI-RADSv2对移行带临床显著癌诊断效能的ROC曲线下面积为0.879;诊断敏感度、特异度、阳性预测值、阴性预测值分别为85.51%、81.72%、75.86%、86.87%。结论两位医师采用PI-RADSv2对前列腺移行带病变的诊断评分结果具有较高一致性,对临床显著癌的诊断一致性高。PI-RADSv2对移行带良、恶性病变有明确的鉴别诊断价值,对移行带临床显著癌有较高的诊断敏感度和特异度。
Objective To determine the diagnostic value of the second version of the prostate imaging reporting and data system （PI-RADSv2） for lesions in prostate transitional zone.Methods Clinical and multi-parameter MRI data of 135 patients with prostate lesions confirmed by pathology were collected.The PI-RADSv2 scores of lesions in prostate transitional zone were calculated by two radiologists independently.Intra-observer reproducibility of the PI-RADSv2 score was assessed by Cohen＇s Kappa test.PI-RADSv2 scores of prostate transitional zone cancer and non-cancerous lesions were calculated and then compared using the independent samples t test.The diagnostic performances of PI-RADSv2 were evaluated using the receiver operating characteristic （ROC） analysis.Results The Kappa values of transitional zone cancer, clinically significant cancer, non-clinically significant cancer （Gleason 3＋3） and non-cancerous lesions were 0.738, 0.807, 0.719 and 0.708, respectively.PI-RADSv2 score of cancer in transitional zone （4.38±0.88） was significantly higher than non-cancerous lesions （2.83±0.84）, （P〈0.05）.ROC curve analysis showed that the area under the curve of PI-RADSv2 score was 0.879, and the sensitivity, specificity, positive predictive value and negative predictive value for clinically significant cancer were 85.51%, 81.72%, 75.86%, 86.87%.Conclusion The scoring results by two radiologists have high consistency for prostate transitional zone lesions by using PI-RADSv2, especially for clinically significant cancer.Benign and malignant lesions in transitional zone of prostate have distinctive PI-RADSv2 scores.PI-RADSv2 score could be used to detect clinically significant prostate cancer with a high diagnostic sensitivity and specificity.
出处
《医学影像学杂志》
2017年第7期1322-1326,共5页
Journal of Medical Imaging
基金
国家自然科学基金项目(项目编号:81271539)
江苏省苏州市临床重点病种诊疗技术专项项目(项目编号:LCZX201406)
江苏省苏州市科技局科技发展计划(应用基础)(项目编号:SYS201475)
关键词
前列腺移行带病变
前列腺影像报告和数据系统
磁共振成像
Prostate lesions in transition zone
Prostate imaging reporting and data system
Magnetic resonance imaging
