摘要
Abstract
Objective:To investigate the value of diagnosis for clinically significant prostate cancer (sPCa) by combining bi-parametric magnetic resonance imaging (B-MRI) with prostate specific antigen density (PSAD) on the basis of the prostate imaging reporting and data system verison 2.0 (PI-RADS V2).Methods:Eighty of prostate cancer,47 patients of benign prostate hyperplasia(BPH) and 4 of prostatitis that were confirmed by biopsy pathology in our hospital were scanned with 3.0T B-MRI(T2WI and DWI).Two diagnostic physicians respectively assessed examination by using the PI-RADS V2 score,doubleblinded to the indication for the MR imaging.All of the results were recorded.To collect the value of prostate specific antigen(PSA),prostate volume and to calculate the value of PSAD.Using the pathological results as the golden standard,the data of different group were analyzed using method of statistics.Results:The average values of PSAD and PI-RADS V2 score were 1.19±0.88,3.90±1.00 in PCa group and 0.38±0.40,2.30±0.55 in non-PCa group respectively.The difference of two groups were statistically significant (PSAD,t=10.10,P＜0.05;PI-RADS,t=5.91,P＜0.05).The area under ROC curve for PSAD and PI-RADS V2 were 0.794,0.894.The diagnostic sensitivity was 98.68％,the specificity was 30％,the positive predictive value(PPV) was 68.18％,the negative predictive value(NPV) was 94.12％ for sPCa with the cutoff point 0.15 of the PSAD.The diagnostic sensitivity was 90.67％,the specificity was 69.23％,the PPV was 81.00％,the NPV was 83.72％ for sPCa with the cutoff point 0.15 of the PI-RADS V2.When PI-RADS V2 score and PSAD combined,a PI-RADS V2 score of 3 and PSAD≥0.15,or PI-PADS V2 score≥4 and PSAD≥0.15,the detection of sPCa were 72％,92％.When a PI-RADS V2score＜3 and PSAD≥0.15,or PI-PADS V2 score≥4 and PSAD＜0.15,the detection of sPCa were 20％,25％.In contrast,when a PI-PADS V2 score≤3 and PSAD＜0.15,there was no sPCa detected.Conclusion:It is very useful to predict biopsy outcome and provides even more accuracy in detecting clinically sPCa when combining B-MRI PI-PADS V2 with PSAD.Patients with a PI-PADS V2 score of ≤3 and PSA density of ＜0.15 may avoid unnecessary biopsies.关键词
前列腺肿瘤/磁共振成像/活组织检查,针吸Key words
Prostatic neoplasms/Magnetic resonance imaging/Biopsy, needle分类
医药卫生
