Does Abstinence From Ejaculation Before Prostate MRI Improve Evaluation of the Seminal Vesicles?
Does Abstinence From Ejaculation Before Prostate MRI Improve Evaluation of the Seminal Vesicles?
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DOI：
10.2214/ajr.16.16278
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发表时间：
2016-12-01
影响因子：
5
通讯作者：
Turkbey, Baris
中科院分区：
文献类型：
--
作者：
Kabakus, Ismail M.;Borofsky, Samuel;Turkbey, Baris
OBJECTIVE.本研究的目的是确定在接受多参数前列腺MRI检查之前是否禁欲会增加精囊（SV）体积，从而提高对SV的诊断解释。材料和方法。这项回顾性研究纳入了238名在4个月内接受前列腺3-T MRI检查的患者。患者被要求完成一份问卷，询问他们上次射精已经多久了（即，< 3 days vs >= 3天）。42例患者（平均患者年龄62.0岁）表示，自上次射精以来不到3天，被指定为第1组，而其余患者表示自上次射精以来间隔3天或更长时间。从其余196例患者中随机选择42例年龄匹配的受试者（平均患者年龄62.1岁），指定为第2组。手动测量SV体积。两名对分组和患者特征不知情的放射科医生分别对右侧和左侧SV进行评分，以确定诊断可解释性，采用3分量表进行评分，如下所示：评分1表示SV未扩张，评分为非诊断性，评分2表示SV未扩张，但评分为诊断性，评分3表示SV扩张，评分为诊断性。使用t检验分析体积差异和可解释性评分。使用Cohen kappa统计分析观察者间一致性。通过卡方检验和相对风险比分析，对60岁及以下患者与60岁以上患者的诊断可解释性差异进行了单独分析。第1组的右侧、左侧和总SV体积分别为3.1 mL、2.9 mL和6.0 mL，而第2组分别为4.7 mL、4.1 mL和8.8 mL（p = 0.011）。第1组和第2组的平均可解释性评分分别为2.0和2.5。对于第1组，阅片人1和阅片人2分别为10名和13名患者分配了非诊断性评分，而对于第2组，他们分别为2名和5名患者分配了非诊断性评分（阅片人1的p = 0.01;阅片人2的p = 0.03）。对于第1组中年龄大于60岁的男性，阅片人1和阅片人2分别对9例和11例患者进行了非诊断性评分;而对于第2组中年龄大于60岁的男性，阅片人1和阅片人2分别对2例和5例患者进行了非诊断性评分（阅片人1的p = 0.01;阅片人2的p = 0.05）。对于60岁以上的男性，在接受MRI检查前禁欲3天或更长时间可导致更大的SV体积和更低的非诊断性评估率，因此可能改善多参数MRI对SV侵袭的评估。在60岁及60岁以下的男性中，这种差异不太明显。
OBJECTIVE. The purpose of the present study is to determine whether abstinence from ejaculation before undergoing multiparametric prostate MRI increases seminal vesicle (SV) volume and therefore improves diagnostic interpretation of the SVs.MATERIALS AND METHODS. This retrospective study included 238 patients who underwent 3-T MRI of the prostate over a 4-month period. Patients were requested to complete a questionnaire that asked how long it had been since their last ejaculation (i.e., < 3 days vs >= 3 days). Forty-two patients (mean patient age, 62.0 years) indicated that it had been less than 3 days since their last ejaculation and were designated as group 1, whereas the remainder indicated an interval of 3 days or more since their last ejaculation. A group of 42 age-matched subjects (mean patient age, 62.1 years) were randomly selected from the remaining 196 patients and were designated as group 2. SV volumes were measured manually. Two radiologists who were blinded to group assignment and patient characteristics scored the right and left SVs separately to determine diagnostic interpretability, which was scored on a 3-point scale as follows: a score of 1 denoted that the SVs were not dilated and the score was nondiagnostic, a score of 2 indicated that the SVs were not dilated but the score was diagnostic, and a score of 3 denoted that the SVs were dilated and the score was diagnostic. Volume differences and interpretability scores were analyzed using a t test. Interobserver agreement was analyzed using the Cohen kappa statistic. A separate analysis was performed to evaluate differences in diagnostic interpretability for patients 60 years and younger versus patients older than 60 years, by use of the chi-square test and relative risk ratio analysis.RESULTS. The right, left, and total SV volumes for group 1 were 3.1 mL, 2.9 mL, and 6.0 mL, respectively, whereas those for group 2 were 4.7 mL, 4.1 mL, and 8.8 mL, respectively (p = 0.011). The mean interpretability scores for group 1 and group 2 were 2.0 and 2.5, respectively. For group 1, reader 1 and reader 2 assigned a nondiagnostic score for 10 and 13 patients, respectively, whereas for group 2, they assigned a nondiagnostic score for two and five patients, respectively (p = 0.01, for reader 1; and p = 0.03, for reader 2). For men in group 1 who were older than 60 years, reader 1 and reader 2 gave a nondiagnostic score for nine and 11 patients, respectively; whereas for men in group 2 who were older than 60 years, the readers gave a nondiagnostic score for two and five patients, respectively (p = 0.01, for reader 1; and p = 0.05, for reader 2).CONCLUSION. For men older than 60 years, abstinence from ejaculation for 3 or more days before undergoing MRI examination resulted in larger SV volumes and lower rates of nondiagnostic evaluation and therefore might improve evaluation of SV invasion on multiparametric MRI. The difference is less striking in men 60 years and younger.