| 刘泽文,李芹,姜小梅,陈永升,陈莹,牛庆亮.MRI定量参数及游离/总前列腺特异性抗原比值诊断前列腺影像报告与数据系统3分临床显著前列腺癌[J].中国医学影像技术,2025,41(5):768~772 |
| MRI定量参数及游离/总前列腺特异性抗原比值诊断前列腺影像报告与数据系统3分临床显著前列腺癌 |
| MRI quantitative parameters and free/total prostate-specific antigen ratio for diagnosing prostate imaging reporting and data system 3-point clinically significant prostate cancer |
| 投稿时间：2025-02-27 修订日期：2025-04-30 |
| DOI：10.13929/j.issn.1003-3289.2025.05.016 |
| 中文关键词: 前列腺肿瘤 磁共振成像 诊断,鉴别 |
| 英文关键词:prostatic neoplasms magnetic resonance imaging diagnosis, differential |
| 基金项目: |
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| 中文摘要: |
| 目的 观察MRI定量参数及游离/总前列腺特异性抗原比值(f/tPSA)诊断前列腺影像报告与数据系统(PI-RADS)3分临床显著前列腺癌(csPCa)的价值。方法 回顾性收集57例PI-RADS 3分前列腺病变患者,包括18例前列腺癌(PCa) 及39例良性增生伴慢性前列腺炎(非PCa组)。将非PCa及ciPCa归为非csPCa组(n=45),对比PCa与非PCa组、csPCa与非csPCa组实验室及MRI参数 ;采用logistic回归,基于单因素分析结果显示组间差异有统计学意义的参数建立联合模型,评估实验室、MRI模型及联合模型鉴别PCa与非PCa及csPCa与非csPCa的效能。结果 PCa组ADC、T1、T2及PD值均低于非PCa组(P均＜0.05),csPCa组f/tPSA、ADC、T1、T2及PD值均低于非csPCa组(P均＜0.05)。以ADC、T1、T2及PD值鉴别PCa与非PCa的AUC分别为0.662、0.755、0.793及0.729,ADC-T1-T2-PD联合模型的AUC为0.839, 高于ADC值(P＜0.05)而与单一T1、T2及PD值差异均无统计学意义(P均＞0.05)。以f/tPSA及ADC、T1、T2、PD值鉴别csPCa与非csPCa的AUC分别为0.692、0.759、0.741、0.805及0.737,ADC-T1-T2-PD联合模型的AUC为0.889,高于单一f/tPSA、ADC及T1值(P均＜0.05)而与单一T2及PD值差异均无统计学意义(P均＞0.05);f/tPSA-ADC-T1-T2-PD联合模型的AUC为0.898,高于单一f/tPSA、ADC、T1及PD值(P均＜0.05)而与单一T2值及ADC-T1-T2-PD联合模型差异均无统计学意义(P均＞0.05)。结论 MRI定量参数联合f/tPSA可有效诊断PI-RADS 3分csPCa。 |
| 英文摘要: |
| Objective To explore the value of MRI quantitative parameters and free/total prostate-specific antigen ratio (f/tPSA) for diagnosing prostate imaging reporting and data system (PI-RADS) 3-point clinically significant prostate cancer (csPCa). Methods Totally 57 patients with PI-RADS 3-point prostate lesions were retrospectively enrolled, including 18 prostate cancer (PCa) (PCa group) and 39 benign hyperplasia with chronic prostatitis (non-PCa group). The former included 12 cases of csPCa and 6 cases of clinically insignificant PCa (ciPCa). Taken non-PCa and ciPCa into non-csPCa group (n=45), laboratory and MRI parameters (apparent diffusion coefficient , T1, T2, proton density values) were compared between PCa and non-PCa groups, also between csPCa and non-csPCa groups. Based on laboratory and MRI parameters being statistically different between groups according to univariate analysis, combined models were established using logistic regression. The efficacy of laboratory, MRI parameters and combined models for differentiating PCa and non-PCa as well as csPCa and non-csPCa were evaluated. Results ADC, T1, T2, PD values in PCa group were all lower those in non-PCa group (all P＜0.05), and f/tPSA, ADC, T1, T2 and PD values in csPCa group were all lower than those in non-csPCa group (all P＜0.05). AUC of ADC, T1, T2 and PD values for differentiating PCa from non-PCa was 0.662, 0.755, 0.793 and 0.729 respectively, while of ADC-T1-T2-PD combined model was 0.839, higher than that of ADC alone(P＜0.05) but not significantly different with T1, T2 and PD values alone (all P＞0.05). AUC of f/tPSA, ADC, T1, T2 and PD values for differentiating csPCa from non-csPCa was 0.692, 0.759, 0.741, 0.805 and 0.737, respectively, while of ADC-T1-T2-PD combined model was 0.889, higher than that of f/tPSA, ADC and T1 values alone (all P＜0.05) but not significantly different with that of T2 and PD value alone (both P＞0.05). AUC of f/ tPSA-ADC-T1-T2-PD combined model was 0.898, higher than that of f/tPSA, ADC, T1 and PD values alone (all P＜0.05) but not significantly different with T2 value and ADC-T1-T2-PD combined model (both P＞0.05). Conclusion MRI quantitative parameters combined with f/tPSA could effectively diagnose PI-RADS 3-point csPCa. |
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