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目的探讨经直肠前列腺超声造影(CEUS)联合MRI靶向穿刺检测前列腺癌的作用。方法选取185例可疑前列腺癌患者,均行经直肠超声(TRUS)检查,对其中40例另行CEUS及MRI检查,所有病例CEUS或MRI检查高度提示为可疑病灶,先实施靶向穿刺活检,再对其余部位给予常规系统穿刺(SB),对照其穿刺病理结果,分析靶向穿刺提高前列腺癌检出率的作用。结果 185例可疑前列腺癌患者中,穿刺病理诊断前列腺癌71例,采用SB法检出53例(28.6%,53/185)。其中40例研究病例中MRI靶向穿刺法检出前列腺癌14例(33.0%,14/40),CEUS靶向穿刺法检出15例(37.5%,15/40),CEUS联合MRI靶向穿刺法检出18例(45.0%,18/40),前三种穿刺法前列腺癌检出率差异无统计学意义(χ2=1.57,P>0.05),但CEUS联合MRI靶向穿刺法高于前三种,差异有统计学意义(χ2=4.07,P<0.05);单个穿刺点的检出率比较:CEUS联合MRI靶向穿刺检出率(60.5%,96/157)高于CEUS靶向穿刺(43.2%,35/81)或MRI靶向穿刺(32.9%,25/76),明显高于SB(11.9%,206/1 732),差异均有统计学意义(P<0.05)。结论经直肠CEUS联合MRI靶向活检可提高前列腺癌的检出率,具有一定的临床应用价值。
Objective To investigate the effect of transrectal ultrasonography (CEUS) and MRI targeted puncture on the detection of prostate cancer. Methods A total of 185 patients with suspected prostate cancer were enrolled in this study. All patients underwent transrectal ultrasound (TRUS) and CEUS and MRI were performed in 40 of them. All cases were highly suspicious of CEUS or MRI examination. First, targeted biopsy was performed and the remaining The patients were given routine systemic puncture (SB). The results of puncture biopsy were analyzed and the effect of targeted puncture on the detection rate of prostate cancer was analyzed. Results Of the 185 patients with suspected prostate cancer, 71 cases were diagnosed as prostate cancer by puncture pathology and 53 cases (28.6%, 53/185) were detected by SB method. Fourteen cases (33.0%, 14/40) were detected by MRI MRI in the 40 cases of the study, 15 cases (37.5%, 15/40) were detected by the CEUS targeted puncture, CEUS combined with MRI-targeted puncture (45.0%, 18/40). There was no significant difference in the positive rates of prostate cancer between the three methods (χ2 = 1.57, P> 0.05). However, CEUS combined with MRI-targeted puncture was higher than the former (Χ2 = 4.07, P0.05). The detection rate of single puncture point was higher than that of CEUS (60.5%, 96/157) (43.2%, 35/81) or MRI targeted puncture (32.9%, 25/76), which was significantly higher than that of SB (11.9%, 206/1 732). There was significant difference between the two groups (P <0.05). Conclusion Rectal CEUS combined with MRI targeted biopsy can improve the detection rate of prostate cancer, and has certain clinical value.