磁共振⁃经直肠超声靶向穿刺联合前列腺病理大切片对前列腺癌精准诊断的优势分析  

MRI⁃TRUS targeted biopsy combined with large⁃section prostate pathology for accurate diagnosis of prostate cancer

作　　者：廖姮 刘逍[1] 朱晓娟 LIAO Heng;LIU Xiao;ZHU Xiao-juan(Department of Ultrasonic Medicine,Huzhou Central Hospital,Huzhou,Zhejiang 313000)

机构地区：[1]湖州市中心医院超声医学科,浙江湖州313000

出　　处：《中华男科学杂志》2022年第1期37-42,共6页National Journal of Andrology

摘　　要：目的:探讨磁共振⁃经直肠超声靶向穿刺联合前列腺病理大切片在前列腺癌诊断中的价值。方法:选取2018年1月至2020年12月在我院就诊的疑似前列腺癌患者310例,根据穿刺方法分为观察组(n=183)和对照组(n=127),观察组给予磁共振与经直肠超声融合引导靶向穿刺,对照组给予标准12针经直肠超声穿刺活检,观察两组前列腺癌诊断情况及穿刺情况。结果:观察组前列腺癌、临床意义显著前列腺癌、临床意义不显著前列腺癌诊断率分别为35.52%、30.60%和4.92%,与对照组比较差异无统计学意义(P>0.05);观察组阳性针数比例、阳性针癌组织长度分别为27.50%和(4.68±1.24)mm,明显高于对照组(P<0.05);观察组中靶向穿刺每例穿刺针数为3(1~5)次,明显少于系统结合靶向穿刺(P<0.05);靶向穿刺和系统结合靶向穿刺前列腺癌、临床意义显著前列腺癌、临床意义不显著前列腺癌诊断率,阳性针数比例及阳性针癌组织长度比较差异无统计学意义(P>0.05);前列腺癌MRI图像特征中:T2WI信号低信号、不规则形、病灶边缘模糊、DWI信号高信号比例分别为诶63.08%、76.92%、83.08%和84.62%,明显高于良性病变(P<0.05),而病灶ADC值为(0.81±0.15)×10^(-3) mm^(2)/s,明显低于良性病变(P<0.05)。结论:磁共振⁃经直肠超声靶向穿刺联合前列腺病理大切片在前列腺癌诊断中有较好的价值,可减少不必要的穿刺针数;同时前列腺良恶性病变在MRI图像上有明显差异。Objective: To investigate the application value of MRI-transrectal ultrasound(TRUS) targeted biopsy combined with large-section prostate pathology in the diagnosis of prostate cancer(PCa). Methods: Totally, 310 patients with suspected PCa underwent MRI-TRUS targeted biopsy combined with large-section prostate pathology(the observation group, n = 183) or standard 12-core TRUS biopsy(the control group, n = 127) in our hospital from January 2018 to December 2020. We compared the findings of biopsies and the detection rate of PCa between the two groups of patients. Results: There were no statistically significant differences between the observation and control groups in the detection rates of PCa(35.52% vs 27.56%, P > 0.05), clinically significant PCa(30.60% vs 23.62%, P > 0.05) and clinically insignificant PCa(4.92% vs 3.94%, P > 0.05). The rate of positive punctures and the length of cancer tissue in the positive puncture were 27.50% and(4.68 ± 1.24) mm in the observation group, significantly higher than 22.38% and(3.70 ± 1.11) mm in the control(P < 0.05). The number of targeted punctures per case was markedly lower than that of system combined with targeted punctures(3 [1-5] vs 15 [13-17], P < 0.05). No statistically significant differences were observed between the targeted biopsy and system combined with targeted biopsy in the detection rates of PCa, clinically significant PCa and clinically insignificant PCa, the rate of positive punctures, or the length of cancer tissue in the positive puncture(P > 0.05). As the MRI features of PCa, the rates of T2 WI low signal, irregular shape, blurred edge of lesions and DWI high signal were 63.08%, 76.92%, 83.08% and 84.62%, respectively, significantly higher than those of the benign lesions(P < 0.05), while the apparent diffusion coefficient(ADC) value of PCa was remarkably lower([0.81 ± 0.15] ×10^(-3) mm^(2)/s) than that of the benign lesions(P < 0.05). Conclusion: MRI-TRUS targeted biopsy combined with large-section prostate pathology has a high application value in

关 键 词：磁共振 超声 靶向穿刺 前列腺癌 应用价值 

分 类 号：R737.25[医药卫生—肿瘤]