摘要
目的探讨单平面双参数磁共振成像(bpMRI)诊断前列腺癌的效能。方法回顾性分析2020年1月至2021年7月于南京医科大学第一附属医院接受经会阴模板磁共振-经直肠超声(MRI-TRUS)认知融合前列腺穿刺活检的343例患者的临床资料。中位年龄65.0(59.0,72.0)岁。中位体重指数(BMI)24.1(22.2,25.6)kg/m2。中位前列腺体积(PV)41.7(29.1,53.3)ml。中位PSA 6.9(5.5,8.4)ng/ml。中位PSAD 0.17(0.12,0.22)ng/ml2。直肠指检异常率6.4%(22/343)。患者均为初次活检。所有患者活检前均行bpMRI检查,采用前列腺影像报告和数据系统2.1版(PI-RADS v2.1)对图像进行判读,PI-RADS评分≥3分为阳性,≤2分为阴性。比较单平面bpMRI和bpMRI两种磁共振检查方法对前列腺癌和有临床意义前列腺癌(csPCa)的检出率。结果单平面bpMRI组结果阴性121例,阳性222例;PI-RADS评分3分95例,4分94例,5分33例。bpMRI组结果阴性141例,阳性202例;PI-RADS评分3分67例,4分102例,5分33例。单平面bpMRI组和bpMRI组对前列腺癌的检出率,在磁共振阴性人群中分别为22.3%(27/121)和15.6%(22/141)(P=0.17),PI-RADS评分3、4、5分亚组中分别为35.8%(34/95)和44.8%(30/67)(P=0.25)、89.4%(84/94)和90.2%(92/102)(P=0.85)、90.9%(30/33)和93.9%(31/33)(P=1.00),差异均无统计学意义。单平面bpMRI组和bpMRI组对csPCa的检出率,在磁共振阴性人群中分别为7.4%(9/121)和2.1%(3/141),差异有统计学意义(P=0.04);在PI-RADS评分3、4、5分亚组中分别为22.1%(21/95)和29.9%(20/67)(P=0.27)、80.9%(76/94)和79.4%(81/102)(P=0.80)、84.9%(28/33)和90.9%(30/33)(P=0.71),差异均无统计学意义。结论对PSA 4~10 ng/ml、PI-RADS≥3分的疑似前列腺癌患者,单平面bpMRI或bpMRI检查对前列腺癌、csPCa有同等的诊断效能。
Objective To explore the efficacy of single-plane bi-parameter magnetic resonance imaging(bpMRI)in the diagnosis of prostate cancer.Methods The clinical data of 343 patients who underwent transperineal template prostate magnetic resonance-transrectal ultrasound(MRI-TRUS)cognitive fusion biopsy at the First Affiliated Hospital of Nanjing Medical University from January 2020 to July 2021 were retrospectively analyzed,with median age of[65.0(59.0,72.0)]years,median body mass index(BMI)of[24.1(22.2,25.6)]kg/m2,median prostate volume(PV)of[41.7(29.1,53.3)]ml,median PSA[6.9(5.5,8.4)ng/ml],median PSAD of[0.17(0.12,0.22)ng/ml2],and abnormal rate of digital rectal examination(DRE)[6.4%(22/343)].All patients underwent initial biopsy and bi-parameter magnetic resonance imaging(bpMRI)examination before biopsy,and the images were interpreted using prostate image reporting and data system version 2.1(PI-RADS v2.1).The detection rates of prostate cancer and clinically significant prostate cancer(csPCa)were compared between single-plane bpMRI and bpMRI.When PI-RADS≥3 score,MRI results were positive;when PI-RADS≤2 score,MRI results were negative.Results In the single-plane bpMRI group,121 MRI results were negative and 222 were positive.Positive patients included 95 with PI-RADS 3 score,94 with PI-RADS 4 score,and 33 with PI-RADS 5 score.In bpMRI group,141 MRI results were negative and 202 were positive.Among the positive patients,67 patients with PI-RADS 3 score,102 patients with PI-RADS 4 score,and 33 patients with PI-RADS 5 score.The detection rates of single-plane bpMRI and bpMRI for prostate cancer were 22.3%(27/121)and 15.6%(22/141)in MRI negative cases[22.3%(27/121)and 15.6%(22/141),P=0.17],and PI-RADS scores with 3 points[35.8%(34/95)vs.44.8%(30/67),P=0.25],4 points[89.4%(84/94)vs.90.2%(92/102),P=0.85]and 5 points[90.9%(30/33)vs.93.9%(31/33),P=1.00]showed no significant difference in stratification.The detection rate of csPCa in the single-plane bpMRI group and bpMRI group was significantly different in the MRI negativ
作者
尚金伟
梁玲辉
承逸飞
赵睿哲
潘敏杰
韩天
王亚民
夏炜
成功
华立新
Shang Jinwei;Liang Linghui;Cheng Yifei;Zhao Ruizhe;Pan Minjie;Han Tian;Wang Yamin;Xia Wei;Cheng Gong;Hua Lixin(Department of Urology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2022年第10期765-769,共5页
Chinese Journal of Urology
关键词
前列腺肿瘤
癌
磁共振成像
活检
Prostatic neoplasm
Cancer
Magnetic resonance imaging
Biopsy
