经直肠三维超声造影断层成像与多参数MRI诊断前列腺癌的对比研究

Comparative study of transrectal three-dimensional contrast-enhanced tomographic ultrasound imaging and multi-parameter MRI in the diagnosis of prostate cancer

目的比较经直肠三维超声造影断层成像(3D-CETRUS TUI)与多参数MRI(mp-MRI)对前列腺癌患者的诊断价值。方法前瞻性选取2017年4月至2019年3月在我院就诊的临床疑似前列腺癌患者164例,所有病例均行3D-CETRUS TUI及mp-MRI检查,并接受经直肠超声引导下经会阴前列腺12针系统穿刺活检术;以穿刺病理结果为金标准,比较两种诊断方法对不同PSA区间(4 ng/ml<PSA≤10 ng/ml、10 ng/ml<PSA≤20 ng/ml、PSA>20 ng/ml)前列腺癌的诊断效能。结果3D-CETRUS TUI与mp-MRI对前列腺癌诊断敏感性分别为75.6%、85.6%,特异性分别为71.6%、81.1%,两者比较差异无统计学意义。4 ng/ml<PSA≤10 ng/ml时,3D-CETRUS TUI与mp-MRI对前列腺癌诊断敏感性分别为51.4%、74.3%,特异性分别为68.4%、81.6%,差异均有统计学意义(均P<0.05);10 ng/ml<PSA≤20 ng/ml时,3D-CETRUS TUI与mp-MRI对前列腺癌诊断敏感性分别为76.1%、78.3%,特异性分别为78.3%、87.0%,差异均无统计学意义;PSA>20 ng/ml时,两种方法的特异性和敏感性均为100%。结论3D-CETRUS TUI技术在对前列腺癌的诊断方面,尤其是当患者PSA>10 ng/ml时,能获得与mp-MRI相似的诊断结论;有望成为前列腺癌诊断及评估的又一重要影像学诊断方法。

Objective To compare the diagnostic value of three-dimensional contrast-enhanced tomographic ultrasound imaging(3D-CETRUS TUI)and multi-parametric MRI(mp-MRI)in patients with prostate cancer.Methods One hundred and sixty-four patients with suspected prostate cancer in our hospital from April 2017 to March 2019 were included.All cases underwent 3D-CETRUS TUI,mp-MRI examination and transperineal prostate 12 needle system puncture under the guidance of transrectal ultrasound.According to the gold standard of puncture pathological results,the diagnostic efficiency of the two methods for prostate cancer with three different PSA leve(l 4 ng/ml<PSA≤10 ng/ml,10 ng/ml<PSA≤20 ng/ml,PSA>20 ng/ml)were analyzed.Results The sensitivity of 3D-CETRUS TUI and mp-MRI for the diagnosis of prostate cancer were 75.6%and 85.6%,the specificity were 71.6%and 81.1%,respectively.There were significant difference(both P<0.05).The sensitivity of 3D-CETRUS TUI and mp-MRI for the diagnosis of prostate cancer with 4 ng/ml<PSA≤10 ng/ml were 51.4%,74.3%,and the specificity were 68.4%and 81.6%,respectively.There were no significant difference.When 10 ng/ml<PSA≤20 ng/ml,the sensitivity of 3D-CETRUS TUI and mp-MRI for the diagnosis of prostate cancer were 76.1%,78.3%,and the specificity were 78.3%%and 87.0%,respectively.There were no significant difference.When PSA>20 ng/ml,the sensitivity and specificity of the two methods were 100%.Conclusion When patients with PSA>10 ng/ml,3D-CETRUS TUI can obtain similar diagnostic conclusions as mp-MRI,and it is more rapid and efficient,so it is expected to become another important imaging diagnosis method for the diagnosis and evaluation of prostate cancer.