经直肠超声结合MRI在前列腺穿刺活检中的诊断价值  

Transrectal Ultrasound Combined with Magnetic Resonance Imaging for Detecting Prostate Cancer in Prostate Biopsy

作　　者：张舜欣[1] 王节[1] 陈穗惠[2] 赵欣[1] 刘欣[1] 李俊来[1] 

机构地区：[1]解放军总医院南楼超声科,北京100853 [2]解放军总医院南楼放射科,北京100853

出　　处：《中国医学影像学杂志》2013年第4期283-285,290,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨经直肠超声结合MRI在前列腺穿刺活检中对前列腺癌(PCa)的检出率。资料与方法 168例疑似PCa患者于穿刺前行经直肠超声和MRI检查,超声与MRI医师共同分析图像,确定可疑病灶。如超声和MRI均未发现病灶,则行系统6针穿刺;如超声和(或)MRI发现病灶,则在病灶横切面与纵切面各取材1针,然后行系统6针穿刺。结合病理结果比较两种影像学检查及二者结合对PCa的检出率。结果 168例患者中,69例为PCa,3例为前列腺上皮肉瘤变,96例为前列腺增生。52例PCa发生于外周腺,6例PCa为弥漫性病变,余11例为移行区肿瘤。穿刺活检前超声诊断PCa的灵敏度及特异度分别为74.0%、53.4%,MRI诊断PCa的灵敏度及特异度分别为80.4%、63.9%,二者联合诊断的灵敏度及特异度分别为84.5%、72.7%。结论经直肠超声结合MRI检查有助于提高PCa的检出率,特别是DWI序列有助于检出移行区PCa。Purpose To explore the diagnostic value of transrectal ultrasound combined with MRI for the detection rate of prostate cancer （PCa） in prostate biopsy. Materials and Methods Transrectal ultrasound and MRI were applied to 168 suspected patients with PCa before puncture, and ultrasound and MRI physician together analyzed the image to determine suspicious lesions. Neither ultrasound nor MRI found the lesion, systematic 6 cores prostate biopsy were used; either of the two imaging found the lesion, the biopsy should be contained puncture one core of both transverse section and longitudinal section of the lesion and then systematic 6 cores biopsy. PCa detection rate was compared for the transrectal ultrasound, MRI and transrectal ultrasound combined with MRI based on the pathological results. Results In the 168 patients, there were 69 cases of PCa （52 cases in peripheral gland, 6 cases in whole gland, and I 1 cased in transitional region） and 99 cases of hyperplasia of prostate gland. Transrectal ultrasound combined with MRI before biopsy could effectively improve the sensitivity and specificity （84.5% and 72.7%） compared with transrectal ultrasound （74.0% and 53.4%） or MR1 （80.4% and 63.9%） separately. Conclusion Transrectal ultrasound combined with MRI before biopsy is an effective method to improve the detection rate of PCa, and DWI sequence especially contributes to detect the prostate cancer in transitional zones.

关 键 词：前列腺肿瘤 超声检查 直肠 磁共振成像 活组织检查 针吸 

分 类 号：R737.25[医药卫生—肿瘤] R730.41[医药卫生—临床医学]