超声多模态影像诊断前列腺癌及指导经直肠超声引导下靶向穿刺  

Ultrasound multimodal imaging for diagnosis of prostate cancer and guiding transrectal ultrasound-guided targeted puncture

作　　者：付尧 苏春 刘永泰 张琳琳 宋奕薇 宋宇[1] 范博 FU Yao;SU Chun;LIU Yongtai;ZHANG Linlin;SONG Yiwei;SONG Yu;FAN Bo(Department of Ultrasonography,the Second Hospital of Dalian Medical University,Dalian 116023,China;Department of Ultrasonography,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Acute Abdomen Surgery,the Second Hospital of Dalian Medical University,Dalian 116023,China;Department of Urology Surgery,the Second Hospital of Dalian Medical University,Dalian 116023,China)

机构地区：[1]大连医科大学附属第二医院超声科,辽宁大连116023 [2]南方医科大学附属南方医院超声科,广东广州510515 [3]大连医科大学附属第二医院急腹症外科,辽宁大连116023 [4]大连医科大学附属第二医院泌尿外科,辽宁大连116023

出　　处：《中国医学影像技术》2023年第3期406-411,共6页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察超声多模态影像诊断前列腺癌(PC)及指导经直肠超声(TRUS)引导下靶向穿刺的价值。方法收集128例前列腺病变患者,包括61例PC及67例良性病变;根据前列腺影像报告和数据系统(PI-RADS)将其分为A组(PI-RADS 3分,n=64)、B组(PI-RADS 4分,n=29)及C组(PI-RADS 5分,n=35),观察TRUS、经直肠实时弹性成像(TRTE)及经直肠超声造影(TR-CEUS)联合诊断PC的效能,分析其用于TRUS引导下靶向穿刺的价值。结果以TRUS、TRTE及TR-CEUS中存在任意2项阳性结果为截断值,超声多模态影像诊断PC的准确率、敏感度、特异度、阳性预测值、阴性预测值及曲线下面积分别为73.44%、77.05%、70.15%、70.15%、77.05%及0.766[95%CI(0.686,0.845)]。随病灶PI-RADS得分升高,超声多模态影像诊断PC的敏感度呈大致下降、而特异度呈上升趋势。结论超声多模态影像有助于诊断PC及制定穿刺活检策略。Objective To observe the value of ultrasound multimodal imaging for diagnosis of prostate cancer(PC)and guiding transrectal ultrasound(TRUS)-guided targeted puncture.Methods Totally 128 patients with prostate diseases were enrolled,including 61 cases of PC and 67 cases of benign diseases.According to prostate imaging reporting and data system(PI-RADS),the patients were divided into group A(PI-RADS 3 points,n=64),group B(PI-RADS 4 points,n=29)and group C(PI-RADS 5 points,n=35).The efficacy of the combination of TRUS,transrectal real-time elastography(TRTE)and transrectal contrast-enhanced ultrasound(TR-CEUS)for diagnosis of PC was observed,and its value for guiding TRUS-guided targeted puncture was analyzed.Results Taken any 2 positive results among TRUS,TRTE and TR-CEUS as the cut-off value,the accuracy,sensitivity,specificity,positive predictive value,negative predictive value and area under the curve(AUC)of ultrasound multimodal imaging for diagnosis of PC was 73.44%,77.05%,70.15%,70.15%,77.05%and 0.766[95%CI(0.686,0.845)],respectively.With the increase of PI-RADS score,the sensitivity of ultrasound multimodal imaging for diagnosis diagnosing PC showed a general downward trend,while its specificity showed an upward trend.Conclusion Ultrasound multimodal imaging was valuable for diagnosing PC and guiding TRUS-guided targeted puncture.

关 键 词：前列腺肿瘤 超声检查 弹性成像技术 磁共振成像 

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