Oon S F, Power S P, Kelly J S, McDermott V, Ryan P, Ryan P C
Bon Secours Hospital, Cork, Ireland,
Ir J Med Sci. 2015 Jun;184(2):313-7. doi: 10.1007/s11845-014-1109-0. Epub 2014 Apr 6.
Magnetic resonance imaging (MRI) has a wide reported variation in sensitivity and specificity for staging prostate cancer (PCA).
We examined the accuracy of MRI in detecting PCA, and in identifying extracapsular extension (ECE) and seminal vesicle invasion (SVI) in PCA patients at our institution.
We retrospectively reviewed pre-biopsy MRI findings and correlated the same with subsequent radical prostatectomy pathology reports in all patients undergoing radical prostatectomy between 2010 and 2012. Specifically, comparison was made between MRI and pathologic stage. Age, serum prostate-specific antigen level and Gleason score were recorded.
MRI detected signal abnormalities in 50 out of 88 PCA patients undergoing radical prostatectomy. Of these, 12 had ECE and 7 had SVI on final histology. The sensitivity and specificity of MRI for detecting ECE were 75 and 100%, respectively. The sensitivity and specificity of MRI for detecting SVI were 16.7 and 100%, respectively. The positive predictive values for determining ECE and SVI were 100% and negative predictive values were 96.2 and 90.6%, respectively.
MRI may be reliable for excluding ECE and SVI in PCA patients where the lesion is visible on MRI. It has a good diagnostic ability for ECE, but is less accurate for identifying SVI. This article supports the use of MRI in the preoperative evaluation of PCA.
据报道，磁共振成像（MRI）在前列腺癌（PCA）分期中的敏感性和特异性存在很大差异。
我们研究了MRI在我院PCA患者中检测PCA、识别包膜外侵犯（ECE）和精囊侵犯（SVI）的准确性。
我们回顾性分析了2010年至2012年间所有接受根治性前列腺切除术患者的活检前MRI检查结果，并将其与随后的根治性前列腺切除病理报告进行关联。具体而言，对MRI和病理分期进行了比较。记录了患者的年龄、血清前列腺特异性抗原水平和Gleason评分。
88例接受根治性前列腺切除术的PCA患者中，MRI检测到50例有信号异常。其中，最终组织学检查显示12例有ECE，7例有SVI。MRI检测ECE的敏感性和特异性分别为75%和100%。MRI检测SVI的敏感性和特异性分别为16.7%和100%。确定ECE和SVI的阳性预测值分别为100%，阴性预测值分别为96.2%和90.6%。
对于MRI上可见病变的PCA患者，MRI在排除ECE和SVI方面可能是可靠的。它对ECE具有良好的诊断能力，但在识别SVI方面准确性较低。本文支持在PCA的术前评估中使用MRI。
