经直肠前列腺超声造影联合MRI靶向活检诊断前列腺癌  

The Diagnosis of Prostate Cancer with Biopsy by Transrectal Contrast Enhanced Ultrasound Combined MRI

作　　者：赖振汉[1] 黄璐[1] 杨舒萍[1] 吕国荣[2] 

机构地区：[1]福建医科大学附属漳州市医院,福建省漳州市363000 [2]福建医科大学附属第二医院超声科

出　　处：《中国超声医学杂志》2016年第8期724-728,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨经直肠前列腺超声造影(CEUS)联合MRI靶向穿刺检测前列腺癌的作用。方法选取185例可疑前列腺癌患者,均行经直肠超声(TRUS)检查,对其中40例另行CEUS及MRI检查,所有病例CEUS或MRI检查高度提示为可疑病灶,先实施靶向穿刺活检,再对其余部位给予常规系统穿刺(SB),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 185例可疑前列腺癌患者中,穿刺病理诊断前列腺癌71例,采用SB法检出53例(28.6%,53/185)。其中40例研究病例中MRI靶向穿刺法检出前列腺癌14例(33.0%,14/40),CEUS靶向穿刺法检出15例(37.5%,15/40),CEUS联合MRI靶向穿刺法检出18例(45.0%,18/40),前三种穿刺法前列腺癌检出率差异无统计学意义(χ2=1.57,P>0.05),但CEUS联合MRI靶向穿刺法高于前三种,差异有统计学意义(χ2=4.07,P<0.05);单个穿刺点的检出率比较:CEUS联合MRI靶向穿刺检出率(60.5%,96/157)高于CEUS靶向穿刺(43.2%,35/81)或MRI靶向穿刺(32.9%,25/76),明显高于SB(11.9%,206/1 732),差异均有统计学意义(P<0.05)。结论经直肠CEUS联合MRI靶向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 assess the utility of combining transrectal contrast enhancement ultrasonography（CEUS）and Magnetic resonance imaging（MRI）targeted biopsy for detection rate of prostate cancer（PCa）.Methods 185 consecutive patients with suspected PCa were selected and received transrectal ultrasonography（TRUS）routinely,whose 40 patients were enrolled by the research,were received CEUS and MRI otherwise.Subsequently,targeted biopsy was used in the suspicious lesions found by CEUS or MRI firstly then other parts were sampled with 8-10-cores systematic biopsy.We analysed the impact of targeted biopsy（TB）on improving the detection rate of PCa by referring the pathological results.Results Cancer was detected in 71 of the 185 patients,53（28.6%,53/185）participants were diagnosed PCa by traditional systematic biopsy,among of these,14 of 40（33.0%,14/40）patients were determined by TB of CEUS,and 15 of 40（37.5%,15/40）patients were determined by TB of MRI,18 of 40（45.0%,18/40）patients were determined by TB of CEUS combined MRI.There was no significant difference among the before three methods（χ~2=1.57,P〉0.05）,but the PCa detection rate by TB of CEUS combined MRI was significantly higher than the before three methods（χ~2=4.07,P〈0.05）.The detection rate for single core by TB of CEUS combined MRI（60.5%,96/157）was significantly higher than TB of CEUS（43.2%,35/81）or TB of MRI（32.9%,25/76）,significantly higher than SB（11.9%,206/1732）（P〈0.05）.Conclusions Prostate biopsy guided by transrectal CEUS combined MRI has a great improvement in detection rate of prostate cancer,which have clinical application value.

关 键 词：经直肠前列腺超声造影 MRI 靶向穿刺 前列腺癌 

分 类 号：R445[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]