超声造影联合MRI定性定位诊断及超声引导下前列腺穿刺活检中的应用价值  

Clinical value of contrast-enhanced ultrasonography combined MRI with qualitative and locative diagnosis and ultrasound guided biopsy of the prostate

作　　者：孔凡雷[1] 方建华[1] 包凌云[1] 韩志江[2] 徐陈柯[1] 陈创华[1] 王炜[1] 

机构地区：[1]浙江省杭州市第一人民医院超声影像科,浙江杭州310006 [2]浙江省杭州市第一人民医院放射科,浙江杭州310006

出　　处：《医学影像学杂志》2014年第11期1970-1973,共4页Journal of Medical Imaging

基　　金：杭州市科技计划引导项目(编号:201302)

摘　　要：目的探讨超声造影联合MRI检查对前列腺癌定性定位诊断及其超声引导下前列腺穿刺活检中的应用价值。方法选取可疑前列腺癌患者190例,经超声造影和MRI检查后,行经会阴前列腺10点传统盲法穿刺活检术,另对超声造影联合MRI发现的可疑病灶区进行靶向穿刺,对照其穿刺病理结果,分析靶向穿刺提高前列腺癌检出率的作用。结果 190例可疑前列腺癌患者中,穿刺病理诊断前列腺癌96例,采用传统盲穿法检出前列腺癌73例,靶向穿刺检出86例,传统盲穿结合靶向穿刺检出96例,采用盲穿法前列腺癌的检出率38.4%(73/190),靶向穿刺的检出率45.3%(86/190),两者比较差异无统计学意义(2=1.828,P=0.176),但传统盲穿法结合靶向穿刺的检出率为50.5%(96/190),较传统盲穿法提高12.1%(23/190),差异有统计学意义(2=5.637,P=0.018);单个穿刺点的检出率比较:靶向穿刺点的检出率(61.4%,162/264)明显高于传统盲穿法的检出率(15.9%,302/1900),差异有统计学意义(2=284.5,P<0.001)。结论超声造影联合MRI检查对前列腺癌定性定位诊断,以其提供信息行超声引导下穿刺活检可提高前列腺癌的检出率,具有一定的临床应用价值。Objective To explore the utility of combining contrast enhanced ultrasonography （CEUS） and magnetic reso‐nance imaging （MRI） in qualitative and locative diagnosis of prostate cancer （PCa） and in ultrasond‐guided biopsy of the prostate .Methods Totally ,190 consecutive patients with suspected PCa were selected and received transrectal CEUS and MRI .Subsequently ,all patients underwent 10 cores‐systematic blind transperineal biopsy .In addition ,targeted biopsy was used in the suspicious lesions found by CEUS and MRI .We analysed the impact of targeted biopsy on improving the detection rate of PCa by referring the pathological results .Results Cancer was detected in 96 of the 190 patients ,73 （38.4% ） participants were diagnosed PCa by traditional blind biopsy ,86（45 .3% ） by targeted biopsy ,and 96 （50 .5% ） by both two methods .There was no significant difference between blind biopsy and targeted biopsy （χ2= 1 .828 ,P =0.176） .The cancer detection rate of combine targeted biopsy resulted in a statistically significant increase comparing with traditional biopsy by 12 .1% （χ2=5 .637 ,P=0 .018） .The detection rate for single targeted biopsy core was significantly higher than traditional blind biopsy cores （61 .4% Vs 15 .9% ,χ2=284 .5 ,P 〈0 .001） .Conclusion Using both CEUS and MRI for qualitative and locative diagnosis of PCa and ultrasound‐guided prostate biopsy could increase the detection of prostate cancer .

关 键 词：前列腺癌 超声造影 磁共振成像 穿刺活检 

分 类 号：R737.25[医药卫生—肿瘤] R445.1[医药卫生—临床医学]