实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (2): 162-166.doi: 10.3969/j.issn.1003-9198.2025.02.012

• 临床研究 • 上一篇    下一篇

剪切波弹性成像联合双参数MRI对老年人临床显著性前列腺癌的诊断价值

朱嘉, 潘永昇, 刘想, 曹心宇, 奚文君, 陈浩, 郑兵, 张忠新   

  1. 222006 江苏省连云港市,连云港市第二人民医院超声科(朱嘉);226000 江苏省南通市,南通大学附属第二人民医院超声科(刘想,曹心宇,奚文君,陈浩,张忠新);泌尿外科(潘永昇,郑兵)
  • 收稿日期:2024-01-05 出版日期:2025-02-20 发布日期:2025-03-03
  • 通讯作者: 张忠新,Email:xixisi@163.com
  • 基金资助:
    江苏省老年健康科研项目(LKM2022059);江苏省干部保健科研项目(BJ21010);南通市卫生健康委员会科研课题(MS2023043);连云港市肿瘤防治科技发展计划项目(QN202419)

Value of shear wave elastography combined with biparametric MRI in the diagnosis of clinically significant prostate cancer

ZHU Jia, PAN Yongsheng, LIU Xiang, CAO Xinyu, XI Wenjun, CHEN Hao, ZHENG Bing, ZHANG Zhongxin   

  1. Department of Medical Ultrasound, The Second People's Hospital of Lianyungang, Lianyungang 222006, China(ZHU Jia); Department of Medical Ultrasound(LIU Xiang,CAO Xinyu,XI Wenjun,CHEN Hao,ZHANG Zhongxin); Department of Urology(PAN Yongsheng, ZHENG Bing), The Second Affiliated Hospital of Nantong University, Nantong 226000, China
  • Received:2024-01-05 Online:2025-02-20 Published:2025-03-03
  • Contact: ZHANG Zhongxin, Email:xixisi@163.com

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摘要： 目的 探讨剪切波弹性成像(SWE)联合双参数MRI(bpMRI)对临床显著性前列腺癌(csPCa)的诊断价值。 方法 收集172例疑诊前列腺癌病人的临床资料,根据穿刺病理分为csPCa组(n=117)与non-csPCa组(n=55),采用ROC曲线分析SWE参数包括最大杨氏模量(Emax)、平均杨氏模量(Emean)、最小杨氏模量(Emin)以及bpMRI前列腺影像报告和数据系统(PI-RADS)评分在不同前列腺体积亚组中诊断外周带、内腺csPCa的价值。 结果 csPCa组与non-csPCa组年龄、总前列腺特异性抗原(tPSA)水平、游离前列腺特异性抗原(fPSA)水平、fPSA与tPSA的比值(f/tPSA)、前列腺特异性抗原密度(PSAD)、前列腺体积、病灶位置、病灶最大径、PI-RADS评分以及异常弹性区域Emax、Emean、Emin差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,Emax、Emean、Emin在前列腺体积≥60 mL组诊断外周带和内腺csPCa的AUC分别为0.706、0.698、0.597和0.763、0.756、0.642,在前列腺体积＜60 mL组诊断外周带和内腺csPCa的AUC分别为0.793、0.787、0.695和0.808、0.809、0.728;bpMRI在前列腺体积≥60 mL和＜60 mL组诊断外周带、内腺csPCa的AUC分别为0.867、0.896以及0.775、0.821,SWE联合bpMRI诊断csPCa的AUC进一步提高。 结论 SWE诊断csPCa时,在前列腺体积较小的亚组中诊断效能更高。SWE联合bpMRI诊断csPCa时,诊断效能进一步提高。   

关键词: 临床显著性前列腺癌, 剪切波弹性成像, 双参数磁共振

Abstract: Objective To investigate the diagnostic value of shear wave elastography(SWE) combined with biparametric MRI(bpMRI)for clinically significant prostate cancer(csPCa). Methods The clinical data of 172 patients with suspected prostate cancer were collected, and they were divided into csPCa group(n=117) and non-csPCa group(n=55) according to the puncture pathology. The predictive value of SWE parameters including maximum Young's modulus(Emax), mean Young's modulus(Emean), minimum Young's modulus(Emin) and bpMRI score for csPCa at different locations in the subgroups with different prostate volumes were analyzed. Results There were statistically significant differences in age, total prostate specific antigen(tPSA), free prostate specific antigen(fPSA), fPSA-to-tPSA ratio(f/tPSA), prostate specific antigen density(PSAD), prostate volume, lesion location, maximum lesion diameter, bpMRI prostate imaging reporting and date system(PI-RADS) score, and Emax, Emean, Emin in abnormal elasticity regions between csPCa group and non-csPCa group(P<0.05).The results of receiver operating characteristic (ROC) curve analysis showed that the areas under the curve(AUCs) of Emax, Emean, Emin in predicting csPCa at peripheral zone and inner gland in the prostate volume ≥60 mL group were 0.706, 0.698, 0.597 and 0.763, 0.756, 0.642,respectively.And in prostate volume <60 mL group, the AUCs were 0.793, 0.787, 0.695 and 0.808, 0.809, 0.728, respectively. The AUCs of bpMRI PI-RADS score in predicting csPCa at peripheral zone and inner gland in the prostate volume ≥60 mL group and prostate volume <60 mL group were 0.867, 0.896, and 0.775, 0.821, respectively. The AUCs of SWE combined with bpMRI PI-RADS score in predicting csPCa were significantly increased. Conclusions SWE has higher diagnostic performance for csPCa in the subgroup with smaller prostate volume. SWE combined with bpMRI has a certain higher clinical value in the diagnosis of csPCa.

Key words: clinically significant prostate cancer, shear wave elastography, biparametric MRI

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