实时超声造影及MRI联合经直肠超声对前列腺癌穿刺检出率的对比研究  

Comparison of Real-time Contrast-Enhanced Ultrasonography and MRI Combined with Transrectal Ultrasonography in the Detection Rate of Prostate Cancer Puncture

作　　者：于立超 黄志鹏 王平 YU Li-chao;HUANG Zhi-peng;WANG Ping(The Third Affiliated Hospital of Southern Medical University,Guangzhou 510665,Guangdong Province,China)

机构地区：[1]南方医科大学第三附属医院,广东广州510665

出　　处：《中国CT和MRI杂志》2023年第6期144-146,共3页Chinese Journal of CT and MRI

基　　金：2021年度广东省卫生健康适宜技术推广项目(202107051122572605)。

摘　　要：目的讨论实时超声造影(CEUS)与磁共振(MRI)分别联合经直肠超声(TRUS)引导前列腺可疑结节穿刺活检对前列腺癌检出率的影响。方法回顾性分析了417例疑似前列腺癌(PCa)患者的临床资料,根据穿刺引导方式分为AB组。A组为CEUS联合TRUS引导经直肠前列腺穿刺活检B组为MRI联合TRUS引导经直肠前列腺穿刺活检。结果两组的年龄并无统计学差异(P=0.741>0.05)MRI联合TRUS与CEUS联合TRUS引导穿刺的结果与病理诊断的结果的一致性均有统计学意义(P<0.001),而TRUS引导穿刺的预后结果与病理诊断的结果的一致性无统计学意义(P=0.777)。CEUS联合TRUS的一致性(Kappa=0.672)要高于MRI联合TRUS(Kappa=0.305)。ROC统计结果显示CEUS联合TRUS的诊断结果明显优于其余两种方法。结论CEUS联合TRUS引导前列腺可疑结节穿刺的方法较MRI联合TRUS及单纯应用TRUS引导前列腺可疑结节的穿刺可以得到更显著的诊断效果。Objective to discuss the effect of real-time contrast-enhanced ultrasound(CEUS)compared with magnetic resonance(MRI)in combination with transrectal ultrasound(TRUS)-guided core needle biopsy of suspicious nodules of the prostate,respectively,on the detection rate of prostate cancer.Methods We retrospectively analyzed the clinical data of 417 patients suspected of prostate cancer(PCA)who were divided into groups a,B,and C according to the puncture guided approach.Group A was CEUS combined with TRUS guided transrectal prostate biopsy,group B was MRI combined with TRUS guided transrectal prostate biopsy,and group C was TRUS guided transrectal prostate biopsy,and the agreement between each examination modality and surgical pathological diagnosis was analyzed by kappa test.Results age was not statistically different among the three groups(P=0.741>0.05);The concordance between the results of MRI combined with TRUS and CEUS combined with TRUS guided puncture and those of pathological diagnosis was statistically significant(P<0.001),whereas the concordance between the prognostic results of TRUS guided puncture and those of pathological diagnosis was not statistically significant(P=0.777).The concordance between CEUS and TRUS(kappa=0.672)was higher than that between MRI and TRUS(kappa=0.305).The ROC statistic results showed that the diagnostic yield of CEUS combined with TRUS was significantly better than the remaining two methods.Conclusions CEUS combined with TRUS guided puncture of prostate suspicious nodules can achieve more significant diagnostic effect than MRI combined with TRUS and TRUS guided puncture of prostate suspicious nodules alone.

关 键 词：前列腺癌 超声造影 经直肠灰阶超声 核磁共振 超声引导下穿刺 

分 类 号：R445.2[医药卫生—影像医学与核医学]