核磁共振联合超声融合成像引导下前列腺靶向穿刺对PI-RADS评分≥3分的前列腺癌患者的诊断价值

The Diagnostic Value of Prostate Targeted Puncture Guided by MRI Combined with Ultrasound Fusion Imaging in Prostate Cancer with PI-RADS Score≥3 Points

为了探讨核磁共振(MRI)联合超声融合成像引导下前列腺靶向穿刺(MR-TRUS)对PI-RADS评分≥3分的前列腺癌患者的诊断价值,本研究选取了进行前列腺癌筛查且MRI检查PI-RADS评分≥3分的患者100例,均行MRI与超声融合靶向穿刺和传统穿刺。并对上述100名患者进行前列腺特异性抗原(PSA)检测,按4<PSA≤10μg/L、10<PSA≤20μg/L、20<PSA≤50μg/L、PSA>50μg/L将融合穿刺方式(A组)和传统穿刺方式(B组)分别分为4个亚组,以术后病理结果为参照,分别比较不同穿刺方式对前列腺癌患者诊断的敏感度、特异度和准确度。结果表明,A组中各亚组的诊断率分别为28.57%、66.67%、70%、91.67%;B组中各亚组的诊断率分别为9.52%、25.00%、60.00%、86.11%。A组中A1和A2亚组患者的诊断率显著高于B组中对应亚组(P<0.05);两种穿刺方式的诊断率在20<PSA≤50μg/L、PSA>50μg/L的亚组中无明显差异(P>0.05)。与B组相比,A组诊断敏感度和准确度显著提高(P<0.05)。综上所述,PSA≤10μg/L和10<PSA≤20μg/L的患者应考虑行MRI联合超声融合靶向穿刺,可显著提高对前列腺癌的诊断率。

In order to explore the diagnostic value of prostate targeted puncture guided by MRI combined with ultrasound fusion imaging (MR-TRUS) in patients with prostate cancer of PI-RADS score ≥3 points, 100 patients who sought medical care in our hospital were enrolled. All of them were performed targeted biopsy via both MR-TRUS guided puncture and traditional puncture. And all the patients were tested the level of prostate specific antigen (PSA). According to 4<PSA≤10 μg /L, 10<PSA≤ 20 μg /L , 20<PSA≤50 μg /L, and PSA>50 μg /L, the MR-TRUS guided puncture group (group A) and the traditional puncture group (group B) were both divided into 4 subgroups. The sensitivity, specificity and accuracy of different puncture methods for the diagnosis of prostate cancer were compared according to the postoperative pathological results. The results showed that the diagnostic rates of each subgroup in the group A were 28.57%, 66.67%, 70% and 91.67%, while the diagnostic rates of each subgroup in the group B were 9.52%, 25.00%, 60.00% and 86.11%, respectively. Compared with the traditional puncture method, MR-TRUS guided puncture significantly improved the diagnostic rate in patients of PSA≤10 μg/L and 10<PSA≤ 20 μg/L ( P <0.05). The diagnostic rate of the two puncture methods was not significantly different in patients of 20<PSA≤ 50 μg/L and PSA>50 μg/L ( P >0.05). Compared with the traditional puncture method, the sensitivity and accuracy of MR-TRUS guided puncture were significantly improved ( P <0.05). In summary, patients of PSA≤10 μg/L and 10<PSA≤20 μg/L should undergo targeted puncture guided by MRI and ultrasound fusion, which can significantly improve the diagnosis rate of prostate cancer.