Department of Radiology, Surgical Planning Lab, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, ASB1-L1-Room 050, Boston, MA, 02115, USA.
Department of Radiology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Abdom Radiol (NY). 2017 Jan;42(1):278-289. doi: 10.1007/s00261-016-0871-z.
The most recent edition of the prostate imaging reporting and data system (PI-RADS version 2) was developed based on expert consensus of the international working group on prostate cancer. It provides the minimum acceptable technical standards for MR image acquisition and suggests a structured method for multiparametric prostate MRI (mpMRI) reporting. T1-weighted, T2-weighted (T2W), diffusion-weighted (DWI), and dynamic contrast-enhanced (DCE) imaging are the suggested sequences to include in mpMRI. The PI-RADS version 2 scoring system enables the reader to assess and rate all focal lesions detected at mpMRI to determine the likelihood of a clinically significant cancer. According to PI-RADS v2, a lesion with a Gleason score ≥7, volume >0.5 cc, or extraprostatic extension is considered clinically significant. PI-RADS v2 uses the concept of a dominant MR sequence based on zonal location of the lesion rather than summing each component score, as was the case in version 1. The dominant sequence in the peripheral zone is DWI and the corresponding apparent diffusion coefficient (ADC) map, with a secondary role for DCE in equivocal cases (PI-RADS score 3). For lesions in the transition zone, T2W images are the dominant sequence with DWI/ADC images playing a supporting role in the case of an equivocal lesion.
前列腺影像报告和数据系统（PI-RADS 版本 2）是基于前列腺癌国际工作组的专家共识制定的。它为磁共振成像（MRI）采集提供了最低可接受的技术标准，并建议了一种多参数前列腺 MRI（mpMRI）报告的结构化方法。T1 加权、T2 加权（T2W）、扩散加权（DWI）和动态对比增强（DCE）成像是建议包含在 mpMRI 中的序列。PI-RADS 版本 2 评分系统使读者能够评估和对在 mpMRI 中检测到的所有局灶性病变进行评分，以确定是否存在临床显著的癌症。根据 PI-RADS v2，具有 Gleason 评分≥7、体积>0.5 cc 或前列腺外延伸的病变被认为具有临床意义。PI-RADS v2 使用基于病变区域位置的主导 MRI 序列的概念，而不是像版本 1 那样对每个组成部分评分进行求和。在周围区，主导序列是 DWI 和相应的表观扩散系数（ADC）图，在不确定的情况下，DCE 起次要作用（PI-RADS 评分 3）。对于移行区的病变，T2W 图像是主导序列，在不确定的病变中，DWI/ADC 图像起辅助作用。
