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目的探讨前列腺影像报告和数据系统第2版(PI-RADS V2)提高前列腺癌影像诊断效能的应用价值。方法初级、中级、高级职称医师各3名,根据各自经验分别对符合入组标准的76例前列腺MRI图像进行经验评分,然后根据PI-RADS V2的评分标准进行2次评分。分析2次PI-RADS V2评分及3个层次医师PI-RADS V2评分的一致性。计算并比较3个层次医师经验评分与PI-RADS V2评分的相关性、经验诊断与PI-RADS V2诊断结果的一致性,对比前列腺癌检出的敏感度、特异度、阳性预测值、阴性预测值,并绘制ROC曲线。结果 2次PI-RADS V2评分结果高度一致,3个层次医师PIRADS V2评分具有较好一致性,3个层次医师经验诊断评分与PI-RADS V2评分正相关(r值分别为0.672、0.805、0.890)。3个层次医师及PI-RADS V2诊断正确率呈递增趋势,无效率呈递减趋势,错误率3个层次医师呈递减趋势,PI-RADS V2错误率略高于高级医师。ROC曲线结果显示高级医师的诊断准确性最高,其次为PI-RADS V2。PI-RADS V2诊断敏感度最高,其次为高级医师。高级医师特异度最高,其次为PI-RADS V2。结论 PI-RADS V2具有良好的可重复性,对于中级、初级医师,PI-RADS V2可以显著提高其对前列腺癌影像诊断效能。
Objective To investigate the value of Prostate Imaging Reporting and Data System 2nd Edition (PI-RADS V2) in improving the diagnostic performance of prostate cancer. Methods Three primary, intermediate and senior professional doctors were divided into three groups. According to their own experience, 76 prostatic MRI images that meet the inclusion criteria were scored empirically and scored twice according to the PI-RADS V2 score. Analyze the consistency of 2 PI-RADS V2 scores and 3 PI-RADS V2 scores of physicians. The correlations between PI-RADS V2 score and the experience of PI-RADS V2 were calculated and compared. The sensitivity, specificity, positive predictive value and negative predictive value of PI-RADS V2 were compared. Value, and draw the ROC curve. Results The results of two PI-RADS V2 were highly consistent. The PIRADS V2 scores of the three levels were in good agreement. The empirical diagnostic scores of three levels were positively correlated with PI-RADS V2 scores (r = 0.672, 0.805 and 0.890, respectively) ). The diagnostic accuracy of the three levels of physicians and PI-RADS V2 showed an increasing trend, the inefficiency showed a decreasing trend, the error rate of three levels of physicians showed a decreasing trend, and the error rate of PI-RADS V2 was slightly higher than that of the senior physicians. ROC curve results showed that senior physicians had the highest diagnostic accuracy, followed by PI-RADS V2. PI-RADS V2 has the highest diagnostic sensitivity, followed by a senior physician. The highest degree of specificity of senior physician, followed by PI-RADS V2. Conclusion PI-RADS V2 has good repeatability. For intermediate and primary physicians, PI-RADS V2 can significantly improve the diagnostic performance of prostate cancer.