MRI引导下软件融合与认知融合穿刺活检对PSA<20 ng/mL患者前列腺癌检出率比较研究  

Comparison of the detection rate of prostate cancer in patients with PSA<20ng/mL under MRI-guided software fusion and cognitive fusion puncture biopsy

作　　者：聂军[1] 罗卫平[1] 李栋[2] 蒋科[1] 杭震宇 王力 吴鸣 赵友 黄琛[3] NIE Jun;LUO Wei-ping;LI Dong(Department of Urology,Liyang People's Hospital(Jiangsu Provincial People's Hospital Liyang Branch),Jiangsu 213300,China)

机构地区：[1]溧阳市人民医院/江苏省人民医院溧阳分院泌尿外科,江苏213300 [2]溧阳市人民医院/江苏省人民医院溧阳分院影像科,江苏213300 [3]苏州大学附属第一医院泌尿外科,江苏215006

出　　处：《放射学实践》2023年第10期1297-1302,共6页Radiologic Practice

基　　金：2020年江苏省重点研发计划专项资金项目(BE2020655);溧阳市人民医院(江苏省人民医院溧阳分院)2019年院级课题(2019YJKT005)。

摘　　要：目的:评估MRI引导下软件融合与认知融合穿刺活检对PSA<20 ng/mL患者前列腺癌检出率的诊断价值。方法:回顾性分析2019年10月-2021年10月在苏州大学附属第一医院和溧阳市人民医院行前列腺组织活检、MRI显示前列腺疑似病变且PSA介于4~20 ng/mL之间的患者共计160例。所有患者先行MRI-TB,随后行经会阴前列腺12针系统穿刺活检术(SB)。患者依照不同TB方法分为软件融合靶向活检组(STB组;苏大附一院)或认知融合靶向活检组(CTB组;溧阳市人民医院),其中STB组85例,CTB组75例。比较STB组和CTB组患者csPCa检出率以及TB+SB和TB的csPCa检出率。结果:两组患者年龄、BMI、PSA水平、DRE阳性人数、PI-RADS评分等一般情况的比较差异均无统计学意义(P>0.05)。STB组与CTB组csPCa总检出率的比较差异无统计学意义(P>0.05)。依照PSA水平进行分层,结果显示STB组和CTB组在PSA 4~10 ng/mL和10~20 ng/mL的患者中csPCa检出率的比较差异无统计学意义(P>0.05)。PI-RADS评分3分、4分、5分的患者中,两组csPCa检出率的比较差异亦无统计学意义(P>0.05)。TB+SB的csPCa总检出率36.9%,而TB的csPCa总检出率31.9%,但二者比较差异无统计学意义(P>0.05)。TB+SB在不同PSA水平分层和不同PI-RADS评分的csPCa检出率均高于TB,差异亦无统计学意义(P>0.05)。结论:软件融合靶向活检和认知融合靶向活检用于前列腺特异性抗原(PSA)水平<20 ng/mL患者csPCa检出率类似。Objective:To evaluate the diagnostic value of multiparametric magnetic resonance imaging-guided targeted biopsy(MRI-TB)for prostate cancer in patients with prostate-specific antigen(PSA)level<20ng/mL.Methods:A retrospective analysis was performed for a total of 160 patients with prostate tissue biopsy and MRI showing suspicious prostate lesions and PSA between 4ng/mL and 20ng/mL in the First Affiliated Hospital of Soochow University and Liyang People's Hospital from October 2019 to October 2021.All patients underwent MRI-TB followed by transperineal prostate 12-needle systematic biopsy(template-guided 12-core systematic biopsy,SB).Patients were divided into software fusion-TB group(STB group from the First Affiliated Hospital of Suzhou University)or cognitive fusion-TB group(CTB group from Liyang People's Hospital)according to different TB methods,including 85 cases in STB group and 75 cases in CTB group.The detection rate of csPCa in STB group and CTB group and the detection rate of csPCa in TB+SB and TB were compared.Results:There was no significant difference in the general conditions such as age,BMI,PSA level,DRE positive number,and PI-RADS score between the two groups(P>0.05).There was no significant difference in the total detection rate of csPCa between the STB group and the CTB group(P>0.05).Stratified according to PSA level,the results showed that there was no significant difference in the detection rate of csPCa between STB group and CTB group in patients with PSA 4~10ng/mL and 10~20ng/mL(P>0.05).In patients with PI-RADS scores of 3,4,and 5,there was no significant difference in the detection rate of csPCa between the two groups(P>0.05).The total detection rate of csPCa for TB+SB was 36.9%,while the total detection rate of csPCa for TB was 31.9%,but there was no significant difference between the two(P>0.05).The detection rate of csPCa of TB+SB in different PSA level stratification and different PI-RADS scores was higher than that of TB,but the difference was not statistically significant(P>0.05).Conclu

关 键 词：前列腺肿瘤 磁共振成像 活组织检查 针吸 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R446.8