本文選題：前列腺癌(PCa)　切入點：前列腺影像報告和數(shù)據(jù)系統(tǒng)(PI-RADS)　出處：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過對前列腺外圍帶和中央腺體病灶進行PI-RADS V2分析評分,以手術(shù)或穿刺活檢的病理檢查結(jié)果為金標準,探討MRS對PI-RADS V2評分3-4分結(jié)節(jié)的假陽性率和假陰性率及其原因。材料與方法:收集了 2015年3月至2016年12月在本院行前列腺檢查且符合入選標準和排除標準的96例患者的臨床和影像資料。入組的96例患者均行常規(guī)MRI、DWI、DCE及MRS檢查,所有患者均經(jīng)手術(shù)和穿刺活檢取得的病理組織證實。依據(jù)第二版前列腺影像報告和數(shù)據(jù)系統(tǒng)(PI-RADS),由兩名主治及以上從事前列腺MRI診斷的影像科醫(yī)師,對入組病例行PI-RADS評分,同時對MRS結(jié)果進行分析。首先將96例患者分為外周帶病變組和中央腺體病變組(以評分最高為標準),篩選出PI-RADS V2評分為3分和4分的結(jié)節(jié),MRS結(jié)果以(Cho+ Cre)/Cit≥0.91為陽性,0.91為陰性,結(jié)果與組織病理學(xué)對照,計算3分和4分前列腺結(jié)節(jié)的MRS假陽性率和假陽性率,同時采用受試者特征曲線獲得曲線下面積,分析MRS結(jié)果與病理結(jié)果的一致性。結(jié)果:1.本研究中的96例前列腺患者中,年齡51-85歲,平均(69. 06±6. 47)歲,病理證實癌31例,非癌65例,外圍帶病變32例,中央腺體病變64例。2.外圍帶PI-RADS評分3分結(jié)節(jié)17例,假陽性3例,假陰性1例。AUC=0.779。敏感性85. 7%,特異性70. 0%,假陽性率30. 0%,假陰性率14. 3%。外圍帶PI-RADS評分4分結(jié)節(jié)15例,假陽性1例,假陰性0例。AUC=0.917。敏感性100%,特異性83. 3%,假陽性率16. 7%,假陰性率0。3.中央腺體PI-RADS V2評分3分結(jié)節(jié)47例,假陽性7例,假陰性1例。AUC=0. 852。敏感性88. 9%,特異性81. 6%,假陽性率18. 4%,假陰性率11.1%。中央腺體PI-RADS評分4分結(jié)節(jié)17例,假陽性4例,假陰性0例。AUC=0. 818。敏感性100%,特異性63. 6%,假陽性率36. 4%,假陰性率0。4.造成前列腺患者診斷假陽性的16例中2例為出血,2例為慢性非特異性肉芽腫性炎,7例為BPH,5例為BPH伴慢性前列腺炎。造成假陰性的2例,1例是微小區(qū)域癌變,1例原因不確切。5.對外周帶PI-RADS V2評分3分的結(jié)節(jié),MRS診斷價值中等(AUC值位于0. 70～0.90之間),對外周帶PI-RADS評分4分的結(jié)節(jié),MRS診斷價值較高(AUC值0.90 ),對中央腺體PI-RADS評分3分和4分結(jié)節(jié),MRS診斷價值中等(AUC值位于0.70～0.90之間)。結(jié)論:1.對外周帶PI-RADS V2評分3分的結(jié)節(jié)和中央腺體PI-RADS評分3分和4分的結(jié)節(jié),MRS診斷價值中等,對外周帶PI-RADS V2評分4分的結(jié)節(jié),MRS診斷價值較高。2. MRS假陽性的原因有出血,良性前列腺增生(尤其是基質(zhì)增生結(jié)節(jié)),慢性非特異性肉芽腫性炎等有關(guān);假陰性的原因可能與病變微小等有關(guān)。
[Abstract]:Objective: to study the false positive rate and false negative rate of PI-RADS V2 score in 3-4 subnodule of PI-RADS V2 score by using PI-RADS V2 analysis of peripheral prostate and central gland as the golden standard of pathological examination of operation or puncture biopsy, and to explore the causes of the false positive rate and false negative rate of PI-RADS V2 score in 3-4 sub-nodule of PI-RADS V2 score by MRS.Materials and methods: the clinical and imaging data of 96 patients who underwent prostate examination in our hospital from March 2015 to December 2016 and met the criteria of inclusion and exclusion were collected.All the 96 patients were examined by conventional MRII-DWII-DCE and MRS, all of them were confirmed by biopsy and operation.According to the second edition of prostatic imaging report and data system PI-RADS, two imaging physicians who were involved in the diagnosis of prostate MRI were evaluated with PI-RADS and the results of MRS were analyzed.At first, 96 patients were divided into peripheral lesion group and central glandular lesion group (with the highest score as the standard, the PI-RADS V2 scores of 3 and 4) were screened out. The results of Mrs with Cho Cre)/Cit 鈮，

本文編號：1711737