多参数磁共振成像在前列腺癌包膜外侵犯预测中的研究进展
Research Progress on Multiparameter Magnetic Resonance Imaging in Predicting Extracapsular Invasion of Prostate Cancer
DOI: 10.12677/acm.2026.1672625, PDF,   
作者: 邓爱卿：湖南师范大学附属第一医院(湖南省人民医院)泌尿外科，湖南 长沙
关键词: 多参数磁共振成像；前列腺癌；包膜外侵犯；Multi-Parameter Magnetic Resonance Imaging； Prostate Cancer； Extracapsular Invasion
摘要: 前列腺癌包膜外侵犯(EPE)是影响患者预后及治疗策略选择的关键病理学特征。精准预测EPE对制定个体化治疗方案具有显著的临床意义。多参数磁共振成像(mpMRI)凭借其无创性、高空间分辨率及多序列成像能力，已成为术前评估EPE的核心影像学手段。然而，当前EPE影像诊断仍面临主观性较强、诊断标准缺乏一致性以及微小侵犯检出灵敏度偏低等问题。近年来，影像组学与人工智能技术的不断突破有望显著提升mpMRI的诊断效能。本文系统回顾了mpMRI成像技术在前列腺癌EPE评估中的优化策略，探讨了mpMRI征象从经验性判读向精准量化分析的发展演变，重点阐述了影像组学在基于mpMRI预测EPE中的应用现状，并深入剖析了mpMRI在微小EPE评估中的局限性，以及在临床整合与成本效益方面所面临的挑战。通过整合现有研究证据，旨在为临床医师提供基于mpMRI的EPE精准诊断策略，助力推动前列腺癌个体化诊疗的进程。
Abstract: Prostate cancer extracapsular invasion (EPE) is a key pathological feature that affects patient prognosis and treatment strategy choices. Accurate prediction of EPE has significant clinical significance for formulating individualized treatment plans. Multiparametric magnetic resonance imaging (mpMRI), with its non-invasive nature, high spatial resolution, and multi-sequence imaging capabilities, has become the core imaging method for preoperative EPE assessment. However, current EPE imaging diagnosis still faces issues such as strong subjectivity, lack of consistency in diagnostic criteria, and low sensitivity in detecting minor intrusions. In recent years, continuous breakthroughs in radiomics and artificial intelligence technologies are expected to significantly enhance the diagnostic performance of mpMRI. This article systematically reviews optimization strategies for mpMRI imaging technology in prostate cancer EPE assessment, explores the evolution of mpMRI features from empirical interpretation to precise quantitative analysis, focuses on the current application of radiomics in MPMRI-based EPE prediction, and provides an in-depth analysis of the limitations of mpMRI in evaluating small EPEs, as well as challenges in clinical integration and cost-effectiveness. By integrating existing research evidence, the goal is to provide clinicians with mpMRI-based EPE precision diagnostic strategies, helping to advance the progress of individualized prostate cancer diagnosis and treatment.
文章引用：邓爱卿. 多参数磁共振成像在前列腺癌包膜外侵犯预测中的研究进展[J]. 临床医学进展, 2026, 16(7): 1115-1125. https://doi.org/10.12677/acm.2026.1672625

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