联合穿刺、靶向穿刺与系统穿刺对前列腺PI-RADS v2.1≥3分患者的诊断效能比较  

Comparison of diagnostic efficacy of combined biopsy,targeted biopsy and systematic biopsy for patients with PI-RADS v2.1 score≥3

作　　者：李拔森 阮亚俊 邓辉[3] 李琴[1] 谭方琴 韩云峰 LI Ba-sen;RUAN Ya-jun;DENG Hui(Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030 [2]华中科技大学同济医学院附属同济医院泌尿外科,武汉430030 [3]华中科技大学同济医学院附属同济医院病理科,武汉430030 [4]华中科技大学同济医学院附属同济医院核医学科,武汉430030

出　　处：《放射学实践》2022年第9期1120-1126,共7页Radiologic Practice

基　　金：分子影像湖北省重点实验室开放基金项目资助(2020fzyx011);同济医院院内基金(2021C12)。

摘　　要：目的:比较基于2.1版前列腺影像报告和数据系统(PI-RADS v2.1)联合穿刺、靶向融合穿刺与系统穿刺对于多参数磁共振(mpMRI)PI-RADS v2.1≥3分患者诊断前列腺癌(PCa)、有临床意义前列腺癌(csPCa)的效能。方法:回顾性分析180例前列腺PI-RADS v2.1≥3分且接受mpMRI与经直肠超声(TRUS)融合前列腺靶向穿刺和系统穿刺患者的病例资料。所有患者均在穿刺前按照PI-RADS v2.1技术规范完成mpMRI检查,MRI-TRUS图像融合后由1位泌尿外科医师经会阴对mpMRI所示可疑前列腺癌病灶行靶向穿刺,再由另1位泌尿外科医师经会阴行12针系统穿刺,综合两者即为联合穿刺。以穿刺病理结果为金标准,比较联合穿刺、MRI-TRUS靶向融合穿刺、系统穿刺对PCa与csPCa的诊断效能。结果:PI-RADS v2.1评分3分者54例,4分者80例,5分者46例。180例中检出PCa132例(73.33%),其中csPCa 105例(58.33%)。在PI-RADS v2.1评分3分组中,联合穿刺、MRI-TRUS融合靶向穿刺、系统穿刺对PCa(χ^(2)=0.579,P=0.749)、csPCa(χ^(2)=0.139,P=0.933)的检出率差异无统计学意义。在PI-RADS v2.1评分4分组中,3种穿刺方法对PCa的检出率差异有统计学意义(χ^(2)=7.313,P=0.026),其中联合穿刺与系统穿刺差异有统计学意义(P<0.0167),而联合穿刺与MRI-TRUS融合靶向穿刺、MRI-TRUS融合靶向穿刺与系统穿刺差异均无统计学意义(P>0.0167);3种穿刺方法对csPCa的检出率差异有统计学意义(χ^(2)=13.631,P=0.001),其中联合穿刺与MRI-TRUS融合靶向穿刺、联合穿刺与系统穿刺差异均有统计学意义(P<0.0167),MRI-TRUS融合靶向穿刺与系统穿刺差异无统计学意义(P>0.0167)。在PI-RADS v2.1评分5分组中,3种穿刺方法对PCa的检出率差异有统计学意义(χ^(2)=7.431,P=0.024),其中联合穿刺与系统穿刺差异有统计学意义(P<0.0167),联合穿刺与MRI-TRUS融合靶向穿刺、MRI-TRUS融合靶向穿刺与系统穿刺差异均无统计学意义(P>0.0167);3种穿刺方法对csPCa的�Objective:To compare the diagnostic efficacy of three biopsy methods based on multi-parametric MRI(mpMRI)prostate imaging reporting and data system version 2.1(PI-RADS v2.1)score≥3 in diagnosing prostate cancer(PCa)and clinically significant PCa(csPCa).Methods:The clinical data of 180 patients with PI-RADS v2.1 score≥3 who underwent mpMRI-transrectal ultrasound(TRUS)fusion targeted biopsy and systematic biopsy were retrospectively analyzed.All patients underwent mpMRI according to PI-RADS v2.1 technical specifications before the biopsy.After MRI-TRUS image fusion,a urologist performed a targeted biopsy of the suspicious prostate cancer lesions shown by mpMRI through the perineum,and another urologist performed a 12-needle system puncture,and the combination of the two was combined biopsy.Taking the pathological results of biopsy as the gold standard,the diagnostic efficacy of combined biopsy,MRI-TRUS fusion targeted biopsy,and systematic biopsy in PCa and csPCa was compared.Results:PI-RADS score was 3 in 54 cases,4 in 80 cases,and 5 in 46 cases.Of all 180 cases,132 cases(73.33%)were PCa,including 105 cases(58.33%)of csPCa.In the group of PI-RADS score 3,there was no statistically significant difference among the three groups in the detection rates of PCa(χ^(2)=0.579,P=0.749)and csPCa(χ^(2)=0.139,P=0.933).In the group of PI-RADS score 4,there was a statistically significant difference among the three groups in the detection rates of PCa(χ^(2)=7.313,P=0.026),among which the difference between combined biopsy and systematic biopsy was statistically significant(P<0.0167),while there was no significant difference between combined biopsy and MRI-TRUS fusion targeted biopsy(P>0.0167),and also between MRI-TRUS fusion targeted biopsy and systematic biopsy(P>0.0167).There was a statistically significant difference among the three groups in the detection rates of csPCa(χ^(2)=13.631,P=0.001),among which the difference between combined biopsy and MRI-TRUS fusion targeted biopsy was statistically significant(P<0.0167),

关 键 词：联合穿刺 靶向穿刺 系统穿刺 前列腺肿瘤 前列腺影像报告与数据系统 多参数磁共振成像 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]