MRI分区定位联合经直肠B超引导前列腺穿刺活检在前列腺癌诊断中的应用

Prostate biopsy guided by transrectal ultrasound combined with MRI compartmental localization in diagnosis of prostate cancer

目的探讨MRI分区定位联合经直肠B超引导前列腺穿刺活检在前列腺癌诊断中的临床应用价值。方法对50例临床前列腺特异抗原(prostate specific antigen,PSA)升高患者行MRI检查并进行12分区,分区与经直肠B超引导穿刺方向、区域一致,然后行经直肠前列腺穿刺术,即在传统穿刺的基础上,增加MRI分区异常区域的穿刺点。统计传统穿刺和传统穿刺联合MRI可疑分区穿刺的前列腺癌阳性率。结果 MRI可疑分区联合传统穿刺前列腺癌阳性率高于传统穿刺(42.0%vs 36.0%,P<0.05)。联合穿刺并发血尿5例,大便带血13例,发热1例,无其他严重并发症。结论 MRI分区定位联合经直肠B超引导前列腺穿刺活检有利于提高前列腺癌穿刺阳性率。

Objective To explore the value of prostate biopsy guided by transrectal ultrasound combined with MRI compartmental localization in the diagnosis of prostate cancer. Methods Fifty patients with elevated prostate specific antigen levels were recruited in this study. All the patients underwent MRI scan before biopsy and the prostate was divided into 12 compartments accordingly. The direction and region of the division were consistent with the ultrasound. Systematic 12-samples needle biopsy was performed and additional biopsy was done for the suspected compartments. According to histopathology, the positive detection rates of systematic 12-samples needle biopsy and systematic biopsy combined with added punctures of suspected compartments were analyzed and compared. Results Prostate cancer detection rate of systematic biopsy combined with punctures of suspected compartment was significantly higher than that of systematic 12-samples needle biopsy （42. 0% vs 36.0%, P〈0. 05）. Systematic biopsy combined with punctures of suspected compartment caused hematuria in 5 cases, bloody stools in 13 cases, and fever in one, and there were no other complications. Conclusion Transrectal ultrasound combined with MRI compartmental localization can improve the outcome of prostate biopsy, benefiting the early diagnosis of prostate cancer