摘要
目的 评价经直肠超声弹性成像、磁共振动态增强及联合应用对前列腺良恶性病变诊断的临床应用. 方法 对60例血清PSA水平高于4.0ng/ml的男性（43~83岁,平均年龄71岁）分别行经直肠超声检查 （transrectal ultrasound,TRUS）,经直肠实时组织超声弹性成像（transrectal real-time elastography,TRTE）及磁共振动态增强检查（dynamic contrast material -enhanced magnetic resonance imaging ,DCE-MRI）. 随后,对这些患者上述检查阳性征象部位针对性靶向活检,同时行常规6针活检,分别比较3种检查方法的前列腺癌阳性检出率. 结果 60例患者中23例为前列腺癌（23/60,38.3%）. TRTE、DCE-MRI及两者联合对于诊断前列腺周缘区恶性病灶的敏感度、特异性及准确性分别为73.9%、78.3%、87.0%,80.1%、75.1%、89.2%及78.3%、76.7%、88.3%. 与TRUS比较,TRTE及DCE-MRI引导下的靶向穿刺活检提高前列腺癌的阳性检出率（ P〈0.05）. 结论TRTE、DCE-MRI检查能够提高对血PSA升高患者前列腺癌病灶的检出率,从而提高前列腺穿刺活检的阳性率,为临床诊断提供强有力的诊断依据.
Objective To compare the value of transrectal real -time elastography （ TRTE） with dynamic contrast material -en-hanced magnetic resonance imaging （DCE-MRI） for prostate cancer detection.Methods A total of 60 men （mean age 71years, range 43 to 83） with serum PSA levels of greater than 4.0ng/ml were assessed using gray -scale transrectal ultrasound （TRUS）, transrectal real-time elastography （ TRTE ） and dynamic contrast material -enhanced magnetic resonance imaging （ DCE -MRI ） .Subsequently , these patients underwent systematic sextant transrectal biopsy and additional biopsies for positive sites on gray -scale TRUS, TRTE and DCE-MRI.The cancer detection rates of the 3 techniques were compared .Results Cancer was detected in 23 of the 60 patients （23/60,38.3%）.TRTE and DCE-MRI had a higher sensitivity, specificity and accuracy of 73.9%,78.3%,87.0%,80.1%,75.1%, 89.2%,78.3%,76.7%,88.3%respectively.TRTE and DCE-MRI guided targeted biopsy improve the positive detection rate of pros-tate cancer, compared with TRUS （P〈0.05）.Conclusion TRTE and DCE-MRI can improve the detection rate of the increase of ser-um PSA in patients with prostate cancer , so as to improve the positive rate of prostate biopsy diagnosis ,provide strong support for clinical diagnosis
出处
《医学研究杂志》
2015年第10期60-63,共4页
Journal of Medical Research
基金
北京市科委"首都临床特色应用研究"(Z141107002514060)
