超声造影及MRI指导前列腺靶向穿刺的临床价值分析

Analysis of Clinical Value of Contrast-Enhanced Ultrasound and MRI in Guiding Prostate-targeted Puncture

目的研究超声造影(CEUS)及MRI指导前列腺靶向穿刺的临床价值。方法选取2016年12月至2018年12月我院PCa疑似癌患者79例,分别进行CEUS和MRI检查,并在直肠超声引导下分别进行系统穿刺和靶向穿刺,然后以术后病理结果为金标准,采用一致性Kappa检验分析系统穿刺、CEUS和MRI指导穿刺对PCa诊断价值并比较三种方法单针阳性率。结果79例患者中PCa占58例(73.42%);系统穿刺、CEUS和MRI指导靶向穿刺诊断灵敏度分别为70.69%、91.38%和86.21%,特异度分别为85.71%、57.14%和71.43%,准确率均为74.68%、82.28%,82.28%,一致性Kappa值分别为0.465、0.517和0.559;CEUS及MRI指导穿刺PCa单针检出率分别为60.87%和58.64%,较系统穿刺(17.97%)明显升高(P<0.05),CEUS与MRI差异无统计学意义(P>0.05)。结论CEUS、MRI指导前列腺靶向穿刺可为穿刺位点提供准确的解剖信息,有利于提升穿刺准确性和病灶检出率,对PCa诊断具有重要价值。

Objective To study the clinical value of contrast-enhanced ultrasound(CEUS)and MRI in guiding prostate-targeted puncture.Methods A total of 79 patients suspected as PCa cancer in our hospital from December 2016 to December 2018 were selected for the study.CEUS and MRI were performed respectively.Systemic puncture and targeted puncture were performed under the guidance of rectal ultrasound,and the postoperative pathological results were used as gold standards,and consistency Kappa test analysis was used to analyze the diagnostic value of systemic puncture and CEUS and MRI-guided puncture for PCa,and the single-needle positive rate of the three methods was compared.Results Among the 79 patients,there were 58 cases(73.42%)of PCa.The diagnostic sensitivities of systemic puncture and CEUS and MRI-guided targeted puncture were 70.69%,91.38%and 86.21%respectively,and the specificities were 85.71%,57.14%and 71.43%respectively,and the accuracy rates were 74.68%,82.28%and 82.28%,and the consistency Kappa values were 0.465,0.517 and 0.559 respectively.The detection rates of single needles by CEUS and MRI-guided puncture for PCa were 60.87%and 58.64%respectively and were significantly increased compared with systemic puncture with 17.97%(P<0.05),and there was no significant difference between CEUS and MRI(P>0.05).Conclusions CEUS and MRI-guided prostate-targeted puncture can provide accurate anatomical information for the puncture site,and are beneficial to improve the accuracy of puncture and the detection rate of lesions.And they are of great value for the diagnosis of PCa.