DiagnosticvalueofDWIwithultrahighbvalueinpredictionofaggressiveprostatecancer / 实用放射学杂志

Objective ToinvestigatethediagnosticvalueofADC withhigherbvaluefortheaggressivenessofprostatecancer. Methods 52patientswithpathologicallyprovedprostatecarcinomawerestudiedretrospectively.AllpatientsunderwentroutineMRI andDWIwithbvalueof1000and2000s/mm2.Accordingtothelocationoflesionfrombiopsyreport,aROIwasdrawnonADC mapatcancerousfociwithlowT2WIandhighDWIsignalintensityrespectivelyandtheADCvalueswerecalculated.Fociwereclassifiedinto highriskgroup(Gleasonscore≥8)andlow-intermediateriskgroup(Gleasonscore≤7).TheADCvaluesatb=1000or2000s/mm2between thetwogroupswerecomparedbyttest.ROCcurvewasusedtodeterminetheabilityofdifferentb-values.Relationshipsbetween meanADCvaluesinfociatb=1000or2000s/mm2andtumorGleasonscorewereassessedusingthe S pear m an test.Results Thereweresignificantdifferencesbetweenthehigh-riskgroupandthelow-intermediategroup(P<0.05)undertwob-values(b=1000s/mm2 andb=2000s/mm2).TheareaundertheROCcurveofb=1000s/mm2andb=2000s/mm2 ADCvaluesindifferentiatingthetwo groupswas0.858(P<0.05)and0.902(P<0.05)respectively,andnosignificantdifferencewasobservedintheAUCofbothgroups(P=0.222). ADCvaluesoftumorregionswerenegativecorrelatedwithtumorGleasonscoreat1000s/mm2(r=-0.709,P<0.05)and2000s/mm2 (r=-0.814,P<0.05)respectively.Although,nosignificantdifferencewasobservedinthecorrelationcoefficient(ρ)betweentwo groups(P=02.09).Conclusion ADCvaluesofbothb=1000and2000s/mm2havecorrelationwithGleasonscores.Thediagnosticperformanceof highb-value(2000s/mm2)ADCissuperiortonormalb-value(b=1000s/mm2)ADCinassessmentoftumoraggressiveness.

ApplicationofmultiGparameterMRIinthediagnosisofprostatecancer / 实用放射学杂志

Objective Toexploretheapplicationvalueofmulti-parametermagneticresonanceimaging(MP-MRI)inthediagnosis ofprostatecancer(PCa).Methods Theclinicaldataof50patientssuspectedasPCaandadmittedbetweenJanuary2017andJanuary 2018wereretrospectivelyanalyzed.Thepathologicalexaminationwasusedasthegoldstandard,andallpatientsunderwentMP-MRI. Theapplicationvalues(sensitivity,specificity,accuracy,positivepredictivevalue,andnegativepredictivevalue)ofMP-MRIwereevaluatedin thediagnosisofPCa.Results Amongsingleexaminationofeachsequence,thesensitivity,accuracyandnegativepredictivevalueof DWIwerehigher,whilethespecificityandpositivepredictivevalueofT2WIwerehigher.ThesensitivityofMP-MRIcombinationwas assameasthatofDWI,butthespecificity,accuracy,positivepredictivevalueandnegativepredictivevaluewerehigherthanthoseof anysingleexamination.PI-RADSscoresofthePCawerehigherthanthoseofthebenignprostatichyperplasiainT2WI,DWI,DCE-MRI and MP-MRIcombination(P＜0.05).TheADCvalueofthePCawaslowerthanthatofthebenignprostatichyperplasia(P＜0.05). Conclusion MP-MRIcombinationcanobtain moreeffectiveinformationforprostatediseases,andhashigherspecificity,accuracy, positivepredictivevalueandnegativepredictivevalueindiagnosingPCa.

Thevalueof3.0T MRreducedfield-of-viewIVIM diffusionweightedimaging ondistinguishingprostatecancerandprostatehypertrophy / 实用放射学杂志

Objective Toinvestigatethevalueof3.0T MRreducedfield-of-view (rFOV)IVIM-DWIondistinguishingprostate cancerandprostatehypertrophy.Methods 30patientswithpathologicallyprovenprostatecancerand38patientswithprostatehypertrophy accordingtotheresultsofbiopsywereanalyzedretrospectively,whounderwent3.0T MRrFOV multipleb-valueDWIscanpreoperatively.The DWIscanwasperformedusing11b-valuesof0,30,50,100,150,200,400,800,1000,1500and2000s/mm2.ADC,slowdiffusion coefficient(D),fastdiffusioncoefficient(D?)andperfusionfraction(f)weremeasuredoncancerousfociandprostatehyperplasiafoci.Allofthe datawereanalyzed.Results TheADC,D,D?andfvaluesoftheprostatecancerwere(0.61±0.12)×10-3 mm2/s,(0.41±0.08)×10-3 mm2/s, (88.0±40.3)×10-3mm2/s,289.3%±29.4%,respectively,and(09.0±01.7)×10-3mm2/s,(05.4±01.3)×10-3mm2/s,(46.1±15.3)×10-3 mm2/s, 474.3%±10.85%,respectively,forprostatehypertrophy.Thedifferencesamongthefourparameterswerestatisticallysignificant(P<0.05).The areasofADC,D,D?andfvaluesunderROCcurvestodistinguishbetweenprostatecancerandprostatehypertrophywere09.32,08.27,01.58,0.976, respectively.Conclusion 3.0T MRrFOVIVIM-DWIcanreflectthetruewaterdiffusion motionandperfusionintheprostate,and maycontributetothedifferentialdiagnosisofprostatecancerandbenignprostatehyperplasia.

Thediagnosticvalueof1.5T multiparametricMRIscoringsystemfordetecting earlyprostatecancerinthecentralglandarea / 实用放射学杂志

Objective Toevaluatethediagnosticvalueof1.5T multiparametricmagneticresonanceimaging (mpMRI)scoring systeminearlycentralprostatecancer(PCa).Methods DataofpatientswhoreceivedprostatempMRIfromJune2014toJune2016 wereanalyzedretrospectively.AccordingtoProstateImagingReportingandDataSystem Version2 (PIGRADS V2),a5Gscorescale wasadoptedandthetwoassociateradiologists,whowereblindedtoanyclinicaldetails,interpretedMRimages.Withthepathological resultsasthediagnosticgoldstandard,theROCcurvewasplottedandtheAUCwascalculated.Thediagnosticsensitivity,specificity, positivepredictivevalueandnegativepredictivevalue,accuracyofPCawerecalculatedunderdifferentdiagnosticthresholds(score3 or4).Results Atotalof41patientswereincludedinthestudyoutofwhich15caseswerethosewithPCaand26caseswithbenign prostatichyperplasia(BPH).TheAUCwas0.733(P＝0.014).Onthediagnosticthresholdscoreof3and4,thesensitivity,specificity, positivepredictivevalue,negativepredictivevalueandaccuracywere73.33%vs40%,61.54%vs92.31%,52.38%vs75%,80%vs 72.73%and65.85%vs73.17%respectively.Conclusion The1.5T mpMRIscoringsystemisrelativelyareliabletechniquefordetecting earlyPCainthecentralglandarea.PatientscanbefollowedGupwithprostatespecificantigen(PSA)whenthescoreislessthan3,and ascoreof4ormoreishighlysuggestiveofPCa.

Pelvic floor muscle exercises with or without electric stimulation and post-prostectomy urinary incontinence: a systematic review / Exercícios dos músculos do assoalho pélvico associados ou não à eletroestimulação e incontinência urinária em pós-prostatectomizados: uma revisão sistemática

Abstract Introduction: Urinary incontinence (UI) after prostatectomy is difficult to treat and causes profound adverse impacts on the individual's quality of life. The main clinical treatments available for post-prostatectomy UI consist of behavioral techniques and physical therapy techniques, such as exercises, electrical stimulation and biofeedback for pelvic floor muscles (PFMs). Objective: To investigate the effectiveness of PFM exercises with or without electrical stimulation for reducing post-prostatectomy UI. Methods: We included only randomized controlled trials (RCTs) which used PFM exercises with or without electrical stimulation. The search was conducted in August of 2013 in the databases of the U.S. National Library of Medicine (MEDLINE), Scientific Electronic Library Online (SciELO), Physiotherapy Evidence Database (PEDro) and Virtual Health Library (VHL). We searched for RCTs published between 1999 and 2013. As keywords for our search, we used the following descriptors from the Health Sciences Descriptors (DeCS): urinary incontinence, pelvic diaphragm, prostatectomy, pelvic floor exercises, electrostimulation and electrical stimulation. We also used the following descriptors from the Medical Subject Headings (MeSH): electrical stimulation, pelvic floor, urinary incontinence, prostatectomy, physiotherapy and exercise therapy. Results: Of the 59 RCTs found, 26 were excluded as duplicates, and 28 were excluded for not displaying a minimum score of 5.0 on the PEDro Scale, which left us with five RCTs. Conclusion: PFM exercises can be effective for treating UI after radical prostatectomy, especially if begun soon after surgery. Associating electrical stimulation with PFM exercises did not show additional benefit for treating urinary incontinence. However, the selected studies presented some methodological weaknesses that may have compromised their internal validity.

Resumo Introdução: A incontinência urinária (IU) pós-prostatectomia é uma complicação de difícil tratamento e que causa um profundo impacto negativo na qualidade de vida do indivíduo. Entre os tratamentos clínicos da IU pós-prostatectomia destacam-se as técnicas comportamentais e as técnicas fisioterapêuticas, como os exercícios, a eletroestimulação e o biofeedback para os músculos do assoalho pélvico (MAPs). Objetivo: Verificar a eficácia dos exercícios MAPs associados ou não à eletroestimulação para a diminuição da IU em pós-prostatectomizados. Métodos: Foram incluídos somente experimentos controlados randomizados (ECRs) que utilizaram como tratamento os exercícios dos MAPs e/ou a eletroestimulação. Realizou-se uma busca em agosto de 2013, nas bases de dados MEDLINE, SciELO, PEDro e BVS, por ECRs publicados entre os anos de 1999 e 2013, e foram utilizadas como descritores contidos nos Descritores em Ciências da Saúde (DeCS) as palavras-título: incontinência urinária, diafragma pélvico, prostatectomia, exercícios do assoalho pélvico, eletroestimulação e estimulação elétrica. Foram utilizadas como descritores contidos no Medical Subject Headings (MeSH) as palavras-título: electrical stimulation, pelvic floor, urinary incontinence, prostatectomy, physiotherapy e exercise therapy. Resultados: Dos 59 ECRs recuperados, 26 foram excluídos por serem duplicados, 28 foram excluídos por não obterem o escore mínimo de 5,0 na Escala PEDro, restando 5 ECRs. Conclusão: Os exercícios dos MAPs podem ser eficazes no tratamento da IU após a prostatectomia radical, principalmente se iniciados cedo. A associação da eletroestimulação aos exercícios dos MAPs parece não potencializar a continência urinária. Contudo, os estudos selecionados apresentaram algumas fraquezas metodológicas que podem ter comprometido suas validades internas..