超声造影剂微血管灌注和MRI联合应用在前列腺癌(PSA灰区)诊断中的价值  

The value of microvessel perfusion based on ultrasound contrast agent combined with MRI in the diagnosis of prostate cancer(PSA grey area)

作　　者：谭伟[1] 丁艳 李霞[1] 赵蕾[1] 刘斌[1] 左云海[3] 

机构地区：[1]青岛市市立医院超声科,山东青岛266000 [2]青岛市市北区妇幼保健计划生育服务中心,山东青岛266000 [3]青岛市市立医院放射科,山东青岛266000

出　　处：《现代肿瘤医学》2017年第20期3316-3319,共4页Journal of Modern Oncology

摘　　要：目的:研究超声造影剂微血管灌注和MRI联合应用在前列腺癌(PSA灰区)诊断中的价值。方法:选择PSA在4~10 ng/ml的患者120例,先进行MRI检查,再进行超声造影剂微血管灌注检查,最后选择MRI和(或)超声造影剂微血管灌注异常区域作为穿刺目标,行10+2点靶向穿刺,MRI和微血管灌注均未发现异常者行常规10点穿刺,病理结果为最终标准。结果:前列腺癌MRI检查的诊断特异度72%,灵敏度71%,符合率72%,阳性预测值68%,阴性预测值75%;经直肠超声和超声造影剂微血管灌注(TRUS+CEUS)的诊断特异度74%,灵敏度69%,符合率72%,阳性预测值69%,阴性预测值74%;超声造影剂微血管灌注联合MRI(CEUS+MRI)的诊断特异度88%,灵敏度87%,符合率88%,阳性预测值86%,阴性预测值89%,CEUS+MRI与MRI、TRUS+CEUS组间比较,差异有统计学意义(P<0.05;P<0.05),MRI与TRUS+CEUS组间比较,差异无统计学意义(P>0.05)。结论:超声造影剂微血管灌注联合MRI能提高前列腺癌(PSA灰区)的诊断水平,有一定的临床意义,进而减少前列腺癌穿刺活检的盲目性,提高靶向性。Objective：To study the value of microvessel perfusion based on uhrasound contrast agent combined with MRI in the diagnosis of prostate cancer （PSA gray area）. Methods：We collected the date with 120 patients of prostatic cancer of prostate specific antigen （PSA） between 4 ng/ml and 10 ng/ml were selected. Then they under- went MRI examination first, and mierovessel perfusion based on ultrasound contrast agent combined with MRI exami- nation next. Targeted biopsy（ 10 ＋ 2） was used in the suspicious lesions detected by microvessel perfusion based on ultrasound contrast agent and （or） MRI. In addition,the rest of the patients underwent 10 cores prostate biopsy. The final criteria was the pathological resuhs. Results：In diagnosing prostate carcinoma, the specificity, sensitivity, coinci- dence rate,positive predictive value and negative predictive value were 72% ,71% ,72% ,68% and 75% with MRI;74% ,69% ,72% ,69% and 74% with trans rectal ultrasound and microvessel perfusion based on ultrasound contrast agent;88% ,87% ,88% ,86% and 89% with microvessel perfusion based on ultrasound contrast agent combined with MRI. The difference between CEUS ＋ MRI and MRI was statistically significant （ P 〈 0.05 ）, as well as between CEUS ＋ MRI and TRUS ＋ CEUS （ P 〈 0.05 ）. There was no statistical significance between CEUS ＋ MRI and MRI （ P 〉 O. 05 ）. Conclusion： Microvessel perfusion based on ultrasound contrast agent combined with MRI could improve the level of prostate cancer （PSA gray area） diagnosis ,reduce the blindness of prostate cancer puncture biopsy, and im- prove the accuracy of searching the target.

关 键 词：前列腺癌 穿刺活检 超声造影 微血管灌注 磁共振成像 灰区 

分 类 号：R737.25[医药卫生—肿瘤]