前列腺磁共振SAD预定位法联合经直肠双平面超声引导在前列腺穿刺的应用

Application of prostate magnetic resonance SAD pre-positioning method combined with transrectal biplane ultrasound guidance in prostate biopsy

目的探讨磁共振SAD(scale、angle、distance)预定位法联合经直肠双平面B超在前列腺穿刺的应用。方法回顾分析了2019年6月至2019年12月我院13例接受前列腺穿刺患者的临床资料。所有患者符合以下条件(1)前列腺磁共振影像学提示前列腺存在可疑结节。(2)总前列腺特异性抗原t PSA<10ng/ml,即t PSA正常或位于灰区患者.所有患者根据前列腺磁共振图像预定位出病灶位置,随后在经直肠双平面B超中通过SAD预定位数值找寻目标区域后进行穿刺。结果本组13例患者中,经病理检查发现前列腺癌患者9例(69.2%)。每位确诊患者病理报告阳性穿刺位点中均有磁共振预定位穿刺点。其中6名患者Gleason评分6分,2名患者Gleason评分7分,1名患者Gleason评分8分。所有患者共穿刺169点位,其中病理提示前列腺癌32点位(18.9%):磁共振预定位下融合靶向穿刺24点位,其中病理提示前列腺癌13点(54.1%),系统穿刺145点位,其中病理提示前列腺癌19点位(13.1%)。均未出现严重并发症。预定位穿刺组阳性率大于系统穿刺组阳性率。结论通过对磁共振的读片、识片定位前列腺癌可疑病灶的位置,进行有针对性的穿刺,有助于提高前列腺癌的检测阳性率,具有较高的临床应用价值。

Objective To investigate the application of SAD(scale,angle,distance)pre-positioning method combined with transrectal biplane B ultrasound in prostate puncture.Methods The clinical data of 13 patients whoreceived prostate puncture in our hospital from June 2019 to December 2019 were retrospectively analyzed.All patients met the following conditions:(1)prostate magnetic resonance imaging showed that the prostate had suspicious nodules.(2)The level of total prostate specific antigen(TPSA)was less than 10 ng/ml,that is,level of t PSA was normal or in the range of gray area.The lesion positions of all patients were located according to the prostate magnetic resonance image,and then the target area was found by SAD pre-positioning value in transrectal biplane B-ultrasound,and then puncture was carried out.Results Of the13 patients,9(69.2%)were confirmed to have prostate cancer by pathological examination.The puncture sites ofthe confirmed patientwere pre-located by MRI.Gleason score of six patients was 6,Gleason scoreof 2 patients was 7,and Gleason score of 1 patient was8.There were 169 puncturepoints in all patients.Of them,32(18.9%)were pathologically diagnosed as prostate cancer.There were 24 pointsfusion targetedpuncture.Of them,13(54.1%)were pathologically diagnosed as prostate cancer.There were 145 points of systematic puncture,of which 19(13.1%)were pathologically diagnosed as prostate cancer.No serious complications occurred.The positive rate of pre-positioning puncture group was higher than that of system puncture group.Conclusion MRI reading and recognizing the location of suspicious prostate cancer lesions will be helpful for improving the positive rate of prostate cancer detection.