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目的探讨分析在前列腺增生和前列腺癌鉴别诊断中磁共振成像(MRI)与前列腺特异性抗原密度(PSAD)联合应用的临床价值。方法对前列腺增生和前列腺癌鉴别诊断的198例患者的临床资料展开回顾性调查分析,均采用MRI、PSAD进行诊断,并在诊断后1周内实施病理检查且得出完整的结果。分析MRI、PSAD单项,及MRI联合PSAD的诊断价值。结果 198例受试者中共有12例经病理检查确定为前列腺癌,构成比为6.06%。在12例病理检查确诊为前列腺癌的患者中,MRI、PSAD、MRI联合PSAD诊断为前列腺癌者分别有10例、9例、9例;在186例病理检查确诊为良性前列腺增生的患者中,MRI、PSAD、MRI联合PSAD诊断为前列腺癌者分别有11例、14例、3例。MRI联合PSAD的灵敏度低于MRI,但MRI联合PSAD鉴别诊断良性前列腺增生和前列腺癌的准确度、特异度、阳性预测值均远高于MRI、PSAD检查。结论在良性前列腺增生与前列腺癌鉴别诊断中,MRI与PSAD联合诊断的价值较高,能够有效减少漏诊和误诊现象。
Objective To investigate the clinical value of combined magnetic resonance imaging (MRI) and prostate specific antigen density (PSAD) in the differential diagnosis of benign prostatic hyperplasia and prostatic cancer. Methods The clinical data of 198 patients with benign prostatic hyperplasia and prostate cancer were retrospectively analyzed. All patients were diagnosed by MRI and PSAD. The pathological examination was performed within 1 week after diagnosis and the complete result was obtained. To analyze the diagnostic value of MRI, PSAD, MRI and PSAD. Results Among the 198 subjects, 12 cases were diagnosed as prostate cancer by pathology, with a ratio of 6.06%. Of the 12 patients diagnosed with prostate cancer by pathology, 10 were diagnosed as prostate cancer by MRI, PSAD and MRI combined with PSAD, 9 and 9, respectively. Of the 186 patients with benign prostatic hyperplasia (BPH) diagnosed by pathology, MRI, PSAD, MRI combined with PSAD diagnosed as prostate cancer were 11 cases, 14 cases, 3 cases. The sensitivity of MRI combined with PSAD was lower than that of MRI. However, the accuracy, specificity and positive predictive value of MRI combined with PSAD in the differential diagnosis of benign prostatic hyperplasia and prostate cancer were much higher than those of MRI and PSAD. Conclusion In the differential diagnosis of benign prostatic hyperplasia and prostatic cancer, MRI and PSAD have high value in diagnosis, which can effectively reduce the missed diagnosis and misdiagnosis.