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[动态对比增强对前列腺影像报告和数据系统第2版外周带扩散加权成像3分的影响]

[Effects of dynamic contrast enhancement on diffusion weighted imaging score of 3 in prostate imaging reporting and data system version 2 of peripheral zone].

作者信息

Wang W, Shao Z H, Huang X H, Xu Y, Feng X, Wang P J

机构信息

Department of Medical Imaging, Tongji Hospital, Tongji University, Shanghai 200065, China.

Department of Radiology, Shibei Hospital, Jing'an District, Shanghai 200435, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2020 Apr 7;100(13):1002-1006. doi: 10.3760/cma.j.cn112137-20190816-01820.

Abstract

To investigate the effects and value of dynamic contrast-enhanced (DCE) on diffusion-weighted imaging (DWI) score 3 in the prostate imaging data and reporting system version 2(PI-RADS V2)of peripheral zone. A retrospective study of consecutive 204 cases of prostate disease in peripheral zone was conducted from January 2015 to January 2018, including 169 cases of prostate cancer and 35 cases of non-prostate cancer. All cases were examined multi-parametric MR imaging on a 3-T MR scanner and confirmed by pathology. Images were analyzed according to PI-RADS V2.Inter-reader agreement of scores was evaluated by kappa coefficient. The constituent ratio of clinically significant prostate cancer (csPCa) in PI-RADS V2 overall scores 3, 3+1 and 4 were calculated and analyzed by non-parametric Chi-square test to determine whether the difference in composition ratio was significant. The positive rate of DCE in diffusion weighted imaging (DWI) score 3 and 4 were calculated. There were 68.6%(140/204) cases in 204 patients with peripheral prostate disease who scored PI-RADS V2 overall score of 3,3+1 and 4. Kappa value was higher for the PI-RADS V2 overallscore of 4 than 3 or 3+1 in the PZ ( values of 0.802 vs 0.737 or 0.591, respectively; all 0.01). The constituent ratio of csPCa in PI-RADS V2 overallscore of 3, 3+1 and 4 were 16.7%(3/18),43.2%(19/44),78.2%(61/78), the difference of which was significant (χ(2)=29.839, 0.05).There was also a significant difference between the constituent ratio of csPCa in the score of 3+1 and 4 (χ(2)=15.286, 0.01).The positive rate of DCE in cases of PI-RADS V2 overall score 3,3+1 and 4 was 76.4%(107/140).The positive rate of DCE incases of DWI score 3 and 4 were 71.0%(44/62), 80.8%(63/78),respectively. DCE has a certain value in PI-RADS V2 due to its high positive rate in the detection of prostate cancer in peripheral zone.DCE is helpful to DWI score 3 to improve the detection rate of csPCa.The PI-RADS V2 overall score 3+1 and 4 in the peripheral zone maybe need to be distinguished due to the different detection of csPCa.

摘要

探讨动态对比增强(DCE)对前列腺影像报告和数据系统第2版(PI-RADS V2)外周带扩散加权成像(DWI)评分为3分的前列腺疾病的影响及价值。回顾性分析2015年1月至2018年1月连续收治的204例外周带前列腺疾病患者,其中前列腺癌169例,非前列腺癌35例。所有患者均在3-T MR扫描仪上行多参数磁共振成像检查,并经病理证实。图像依据PI-RADS V2进行分析。评分的阅片者间一致性采用kappa系数评估。计算并采用非参数卡方检验分析PI-RADS V2总分3、3+1及4分中临床显著性前列腺癌(csPCa)的构成比,以确定构成比差异是否具有统计学意义。计算DWI评分为3分和4分的病例中DCE的阳性率。204例外周带前列腺疾病患者中,PI-RADS V2总分3、3+1及4分的病例共68.6%(140/204)。外周带PI-RADS V2总分4分的kappa值高于3分或3+1分(分别为0.802、0.737及0.591;P均<0.01)。PI-RADS V2总分3、3+1及4分中csPCa的构成比分别为16.7%(3/18)、43.2%(19/44)、78.2%(61/78),差异具有统计学意义(χ²=29.839,P<0.05)。3+1分与4分中csPCa的构成比差异也具有统计学意义(χ²=1

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