Comparison of Cognitive Registration Transrectal Ultrasound-Guided Targeted Biopsy of Prostate to Systematic 12-Core Biopsy: A Retrospective, Multicentre Study

Introduction: Prostate cancer (PCa) is the third most prevalent cancer among Malaysian males, often diagnosed at advanced stages, leading to suboptimal outcomes. While transrectal ultrasound-guided systematic biopsy (TRUS-SB) is the primary diagnostic method, prebiopsy multiparametric magnetic resonance imaging (mpMRI) is gaining popularity in identifying suspicious lesions. This study addresses the lack of comprehensive investigations into the efficacy of cognitive registration TRUS targeted biopsy (COG-TB) compared to conventional TRUS-SB, considering the resource limitations of the Malaysian healthcare system. Materials and Methods: A retrospective cohort study was conducted in two Malaysian healthcare facilities. 116 adult patients with a prostate-specific antigen (PSA) level of more than 4 ng/mL who underwent both COG-TB and TRUS-SB between October 2020 and March 2022 were included. Primary outcomes were cancer detection rate and histopathological outcomes, including Gleason score. Results: COG-TB showed a higher overall cancer detection rate (50%) compared to TRUS-SB (44%). Clinically significant cancer detection rates were similar between COG-TB and TRUS-SB (37.1%). Further analysis revealed that both COG-TB and TRUS-SB detected clinically significant cancer in 30.2% of patients, did not detect it in 56.0%, and had conflicting findings in 16 patients (p Conclusion: COG-TB and TRUS-SB have comparable detection rates for clinically significant prostate cancer, with COG-TB showing a higher tendency to detect insignificant prostate cancer. Further studies comparing these methods are warranted.

mpMRI/TRUS融合引导下前列腺靶向穿刺活检中漏诊原因

目的:研究多参数磁共振成像(mpMRl)/手指引导、经直肠超声(TRUS)融合引导下的前列腺靶向穿刺活检(TB)中漏诊的原因。方法:回顾性分析2021年1月~2023年9月山东省荣军总医院行经会阴前列腺穿刺活检的97例患者的临床资料。在mpMRI和Pl-RADS评分后完成了mpMRI/TRUS融合引导的前列腺经会阴TB+经会阴系统穿刺活检(SB)。比较TB和SB的病理诊断,评价和分析TB漏诊的原因。结果:共有52例患者被确诊为前列腺癌,其中TB漏诊5例(9.62%),SB漏诊6例(11.53%)。TB漏诊组和未漏诊组之间年龄比较差异无统计学意义(P>0.05),但前列腺特异性抗原(PSA)、前列腺体积(PV)、PSA密度(PSAD)及国际泌尿病理学学会(ISUP)等级比较,差异有统计学意义(P<0.05)。将5例TB漏诊的病理结果与磁共振成像(MRI)进行重新比较:3例前列腺癌MRI正常,1例癌灶MRl异常,1例癌灶MRI升级为Pl-RADS 3。结论:早期前列腺癌、大前列腺、局部麻醉及患者的配合、MRI阅读人员和穿刺操作人员的经验都可能是TB漏诊的原因。故个性化的活检计划、更好的成像技术、丰富的操作和阅片经验以及更智能的融合系统能够降低漏诊率,提高TB阳性率。

Value of contrast-enhanced ultrasound in deep angiomyxoma using a biplane transrectal probe:A case report

BACKGROUND Deep angiomyxoma(DAM)is a very rare tumor type.Magnetic resonance imaging(MRI)is considered the best imaging modality for diagnosing DAM.Computed tomography(CT)is used mainly to assess the invasion range of DAM.The value of ultrasonography in the diagnosis of DAM is still controversial.Through a literature review,we summarized the current state of ultrasonic examination for DAM and reported for the first time the contrast-enhanced ultrasound(CEUS)features of DAM seen using a biplane transrectal probe.CASE SUMMARY A 37-year-old woman presented with a sacrococcygeal mass that had gradually increased in size over the previous 6 mo.MRI and CT examinations failed to allow a definite diagnosis to be made.Transperineal core needle biopsy(CNB)guided by transrectal ultrasound and CEUS was suggested after a multidisciplinary discussion.Grayscale ultrasound of the lesion showed a layered appearance with alternating hyperechoic and hypoechoic patterns.Transrectal CEUS showed a laminated distribution of the contrast agent that was consistent with the layered appearance of the tumor on grayscale ultrasound.We performed transperineal CNB of the enhanced area inside the tumor under transrectal CEUS guidance and finally made a definitive diagnosis of DAM through histopathology.The patient underwent laparoscopic-assisted transabdominal surgery combined with transperineal surgery for large pelvic tumor resection and pelvic floor peritoneal reconstruction.No recurrence or metastasis was found at the ninemonth follow-up.CONCLUSION Transrectal CEUS can show the layered perfusion characteristics of the contrast agent,guiding subsequent transperineal CNB of the enhanced area within the DAM.

TRUS诊断在直肠癌患者术前分期中的应用价值

目的探讨在直肠癌手术患者术前分期中采取经直肠超声检查(TRUS)诊断的价值。方法河北北方学院附属第一医院在2020至2021年收治的直肠癌手术患者中选取70例,均在术前采取MRI、TRUS方法对病情进行分期,金标准为手术病理分期结果,对两种方法在术前分期诊断中的基本和完全符合率以及灵敏度、特异度、准确率等作比较。结果术前MRI分期结果与金标准相比,完全符合率为65.71%(46/70),基本符合率为80.00%(56/70),术前TRUS分期结果与金标准相比,完全符合率为78.57%(55/70),基本符合率为94.29%(66/70),TRUS检查方法在直肠癌术前分期中的灵敏度高于MRI,但差异无统计学意义(P>0.05)、TRUS检查特异度、准确率相比于MRI方法更高,组间比较差异有统计学意义(P<0.05)。结论在直肠癌术前分期诊断中,TRUS方法分期基本符合率接近病理分期结果,与MRI方法分期诊断结果相比特异度、准确率更高,因此可大力应用在直肠癌术前分期诊断中,为临床治疗提供参考依据。

The performance of transrectal ultrasound in the diagnosis of seminal vesicle defects： a comparison with magnetic resonance imaging

Obstructive azoospermia （OA） is one of the most common causes of male infertility. Transrectal ultrasound （TRUS） has been used to diagnose OA for many years. From 2009 to 2013, we evaluated a prospective cohort of 1249 patients with suspected OA using TRUS. It was found that dilation of the ejaculatory duct （ED） （29.9%, 374/1249） was the most common cause of OA, followed by seminal vesicle （SV） abnormalities （28.5%, 356/1249）. A total of 237 patients were diagnosed with congenital defects （agenesis and/or hypoplasia） of the SV, constituting more than half of the cases of SV disease in OA （19.0%, 237/1249）. In contrast to ED, congenital defects of the SV could not be corrected with surgical treatment. Therefore, it is meaningful to compare TRUS and magnetic resonance imaging （MRI） for accurate diagnosis of SV defects. Among our patients, 30 with agenesis or/and hypoplasia of the SV on TRUS were further evaluated using pelvic MRI within 2 years, with the objective of verifying the TRUS results. The concordance rate for diagnosing congenital defects of the SV was 73.3% （22/30）. We concluded that TRUS is a reliable and convenient method for diagnosing agenesis or hypoplasia of the SV in OA patients with a high concordance with MRI while MRI is useful in patients with inconclusive TRUS findings.

1.5T MRI与TRUS成像特点在肛周脓肿诊断及分型中的差异性研究

目的:探讨磁共振成像(MRI)与经直肠双平面超声(TRUS)成像特点在肛周脓肿疾病诊断及分型中的差异性。方法:选取医院收治的104例肛周脓肿患者,按照诊断方法的不同将其分为TRUS组和MRI组,每组52例。TRUS组予以TRUS检查,MRI组予以1.5T的MRI检查,对比两组患者肛周脓肿检测的临床分型多发脓肿、深部脓肿和定位内口诊断正确率及I期根治率。结果:TRUS组的肛周脓肿分型中多发脓肿、深部脓肿和定位内口诊断正确率明显高于MRI组,差异有统计学意义(x^2=7.930,x^2=9.640,x^2=4.270;P<0.05);TRUS组的I期根治率明显高于MRI组,差异有统计学意义(x^2=7.120,P<0.05)。结论:TRUS检查对肛周脓肿的诊断效果优于MRI检查,可为临床诊断分型提供影像学依据。

TRUS引导下前列腺穿刺活检联合PSA水平变化在诊断前列腺癌中的价值

目的探讨经直肠内超声(TRUS)引导下前列腺穿刺活检联合血清前列腺特异性抗原(PSA)诊断前列腺癌(PCA)的临床价值。方法选取怀疑为PCA的患者128例,分别接受TRUS引导下前列腺穿刺活检、血清PSA检测,以最终病理学检查结果作为金标准,探讨二者联合诊断PCA的临床价值。结果不同PSA水平下TRUS引导下前列腺穿刺活检对PCA的检出率比较,差异有统计学意义(P﹤0.001)。血清PSA检测鉴别诊断PCA的灵敏度为72.97%,特异度为61.11%,漏诊率为27.03%,误诊率为38.89%;TRUS引导下前列腺穿刺活检鉴别诊断PCA的灵敏度为70.27%,特异度为61.11%,漏诊率为29.73%,误诊率为38.89%;TRUS引导下前列腺穿刺活检联合血清PSA检测鉴别诊断PCA的灵敏度为98.65%,特异度为87.04%,漏诊率为1.35%,误诊率为12.96%。结论 TRUS引导下前列腺穿刺活检联合血清PSA检测诊断PCA的临床价值高于二者单独应用。

MRI联合TRUS检查对前列腺癌穿刺检出率的影响

探讨核磁共振(MRI)联合经直肠超声(TRUS)检查对前列腺癌穿刺检出率的影响。回顾性分析150例疑似前列腺癌患者的临床资料,根据穿刺指导方式将其分为A组、B组、C组,A组于TRUS引导下穿刺,B组于MRI引导下穿刺,C组于MRI联合TRUS引导下穿刺。经Kappa检验分析各检查方式与手术病理诊断的一致性,记录三组并发症发生率。结果显示,A组、B组、C组结果与病理诊断的一致性分别为0.505、0.585、0.664;三组血便、尿潴留、血尿、低热发生率比较无显著差异(P>0.05)。与单纯MRI或TRUS引导下行前列腺穿刺相比,采用MRI联合TRUS引导下进行前列腺穿刺与手术病理诊断的一致性最高。

Transrectal ultrasound examination of prostate cancer guided by fusion imaging of multiparametric MRI and TRUS:avoiding unnecessary mpMRI-guided targeted biopsy

The purpose of this study was to explore transrectal ultrasound(TRUS)findings of prostate cancer(PCa)guided by multiparametric magnetic resonance imaging(mpMRI)and to improve the Prostate Imaging Reporting and Data System(PI-RADS)system for avoiding unnecessary mpMRI-guided targeted biopsy(TB).From January 2018 to October 2019,fusion mpMRI and TRUS-guided biopsies were performed in 162 consecutive patients.The study included 188 suspicious lesions on mpMRI in 156 patients,all of whom underwent mpMRI-TRUS fusion imaging-guided TB and 12-core transperineal systematic biopsy(SB).Univariate analyses were performed to investigate the relationship between TRUS features and PCa.Then,logistic regression analysis with generalized estimating equations was performed to determine the independent predictors of PCa and obtain the fitted probability of PCa.The detection rates of PCa based on TB alone,SB alone,and combined SB and TB were 55.9%(105 of 188),52.6%(82 of 156),and 62.8%(98 of 156),respectively.The significant predictors of PCa on TRUS were hypoechogenicity(odds ratio[OR]:9.595,P=0.002),taller-than-wide shape(OR:3.539,P=0.022),asymmetric vascular structures(OR:3.728,P=0.031),close proximity to capsule(OR:3.473,P=0.040),and irregular margins(OR:3.843,P=0.041).We propose subgrouping PI-RADS score 3 into categories 3a,3b,3c,and 3d based on different numbers of TRUS predictors,as the creation of PI-RADS 3a(no suspicious ultrasound features)could avoid 16.7%of mpMRI-guided TBs.Risk stratification of PCa with mpMRI-TRUS fusion imaging-directed ultrasound features could avoid unnecessary mpMRI-TBs.

MR—DWI联合TRUS在前列腺癌诊断及Gleason分级中的应用

【目的】探讨磁共振扩散成像（MR-DWI）联合经肠道超声检查（TRUS）对前列腺癌的诊断价值及其在Gleason分级中的应用。【方法】选取2015年6月至2017年7月本院收治的前列腺良恶性疾病患者98侧为研究对象，术前均行MR-DWl、TRUS检查，记录表观扩散系数值（ADC），并将诊断结果与病理学诊断结果比较。同时，比较不同的检测方法的敏感度、特异性、准确度，并对Adc值与Gleason评分相关性进行分析。【结果】98例中，前列腺癌43例，良性前列腺增生40例，前列腺炎15例。前列腺癌患者ADC值显著低于前列腺增生患者及前列腺炎患者，差异具有统计学意义（P〈0．05）。前列腺癌患者不同TNM分期中ADC值由大到小依次为Ⅰ期〉Ⅱ期〉Ⅲ期〉Ⅳ期，但组间比较差异无统计学意义（P〉0．05）。MR—DWI、TURS、MR—DWI＋TRUS诊断前列腺癌的敏感度分别为86．0．4％、74．48％、95．34％，特异性分别为83．63％、78．18％、89．09％，准确率分别为84．69％、74．49％、91．83％，MR—DWI＋TRUS诊断前列腺癌的准确度最高，明显高于其余两种方法。相关性分析结果显示，前列腺癌患者ADC值与Gleason评分呈负相关。【结论】MR—DWI联合TRUS对前列腺癌的诊断及病情的预测具有较高的准确性，值得在临床推广。

血清t-PSA、f-PSA/t-PSA、DRE及TRUS对前列腺癌的诊断价值分析

目的探讨前列腺特异抗原(t-PSA)、游离PSA与总PSA比值(f-PSA/t-PSA)、直肠指诊(DRE)和直肠超声(TRUS)诊断前列腺癌(PCa)的价值。方法回顾性分析经病理诊断的31例PCa患者和34例前列腺增生(BPH)患者的血清PSA水平、f-PSA/t-PSA比值、DRE和TRUS的检测结果。结果 ROC曲线分析结果显示t-PSA和f-PSA/t-PSA对PCa的诊断敏感性分别为67.7%和77.4%,特异性分别为58.8%和73.5%,曲线下面积(AUC)分别能达到0.659和0.808。而DRE和TRUS对PCa的诊断敏感性分别为58.1%和51.6%,特异性分别为82.3%和73.5%。联合f-PSA/t-PSA与DRE或TRUS检测,对PCa的诊断敏感性分别上升到87.1%和83.9%,3项指标联合可提高诊断敏感性至90.3%。结论 f-PSA/t-PSA比t-PSA更适合用于临床PCa的诊断,联合f-PSA/t-PSA,TRUS和DRE检查可明显提高临床PCa的检出率。

TRUS及超声造影联合MRI引导前列腺靶向穿刺的临床研究

目的探讨经直肠超声(transrectal ultrasound,TRUS)及超声造影联合MRI引导前列腺靶向穿刺的临床应用价值。方法对行前列腺穿刺活组织检查并经手术病理证实的187例患者进行回顾性分析,其中前列腺10点系统穿刺患者102例,靶向穿刺患者85例,比较2组穿刺前列腺癌检出率、穿刺针数及Gleason评分情况。结果靶向穿刺组穿刺阳性率和术后病理符合率高于系统穿刺组,差异有统计学意义(P<0.05);2组术后病理前列腺癌检出率差异无统计学意义(P>0.05)。85例靶向穿刺患者中高危组穿刺286针,危险组158针,可疑组105针,补针组63针,高危组穿刺阳性率高于可疑组和补针组,差异有统计学意义(P<0.05)。靶向穿刺组术后Gleason评分的高分符合率高于系统穿刺组,差异有统计学意义(P<0.05);2组穿刺结果和术后病理结果的Gleason评分差异无统计学意义(P>0.05)。结论 TRUS及超声造影联合MRI引导前列腺靶向穿刺能明显提高前列腺癌检出率,且减少了穿刺针数,能提高较高Gleason评分前列腺癌的检出率,有较高的临床应用价值。

TRUS引导下6+X点穿刺活检法诊断前列腺癌的临床价值

目的:探讨经直肠超声(transrectal ultrasound,TRUS)引导下的6+X点穿刺活检方法对前列腺癌的临床诊断价值。方法:对88例疑似病例分别行TRUS引导下6点系统活检,及可疑X点定目标活检。结果:88例病人经穿刺取材病理证实,前列腺癌41例,良性前列腺增生41例,前列腺炎1例,前列腺增生合并炎症3例,非典型增生1例,前列腺结核1例。采用6+X点穿刺活检法对前列腺癌的检出率为46.6%,其灵敏度为95.3%,特异度及阳性预告值为100%。结论:TRUS引导下6+X点穿刺活检法可以提高前列腺癌的检出率,可为前列腺疾病的临床诊断,鉴别诊断及治疗方案的选择提供组织学依据。

CE-TRUS引导前列腺穿刺活检的临床价值

目的 探讨经直肠超声造影在前列腺穿刺活检中的临床价值.方法 选择临床疑诊为前列腺癌预行经直肠前列腺穿刺活检术的68例患者,分为对照组(30例)和造影组(38例),所有患者均采用10点系统穿刺法行前列腺穿刺活检,造影或者常规超声提示可疑病灶处增加1~2针.比较两组患者穿刺病理结果、病理阳性率及两组的敏感性、特异性、准确性.结果 造影组病理阳性率(36.9%)显著高于对照组(27.0%)(P<0.05).经直肠超声造影引导前列腺穿刺活检对诊断前列腺癌的敏感性、特异性和准确性(82.4%、71.4%、76.3%)均显著高于经直肠超声引导的前列腺穿刺活检(64.2%、56.3%、60.0%)(P<0.05).结论 经直肠超声造影引导下前列腺穿刺活检提高前列腺癌的检出率,但由于假阴性和假阳性的存在,经直肠超声造影引导前列腺穿刺仍无法代替系统穿刺.

经直肠超声(TRUS)在经尿道膀胱肿瘤电切术(TURBT)的应用价值研究

目的:探讨经直肠超声(TRUS)在经尿道膀胱肿瘤电切术(TURBT)的应用价值。方法:采用指肠超声对于拟行尿道膀胱肿瘤电切术的57例尿道膀胱肿瘤患者进行检查,观查肿瘤侵润情况,同时与术后病理结果进行比较。结果:本研究的57例患者中,有35例患者经直肠超声显示肿瘤侵润程度超出粘膜层,其中有6例患者肿瘤深度达到浆膜层;经直肠超声能够较为准确的判断肿瘤对于膀胱壁的损害及是否出现肌层侵润,与病理诊断价格比较,其诊断符合率为87.7%(50/57)。结论:经直肠超声对于膀胱肿瘤具有很好的诊断价值,能够对膀胱肿瘤是否出现肌层侵润进行准确的判断,可以在临床上推广应用。

The diagnostic value of transrectal ultrasonographic features in prostate cancer

Objective:The aim of the study was to detect the valuable ultrasonographic features in diagnosing prostate cancer.Methods:The patients who underwent transrectal ultrasound in the period from May 2005 to October 2009 at the 1st Affiliated Hospital of Dalian Medical University,China,were included,with needle biopsy diagnosis for patients with the prostate cancer and prostatic hyperplasia.Seventy-four cases of prostate cancer were diagnosed as adenocarcinoma,compared with 51 cases diagnosed as prostatic hyperplasia.Retrospective analysis of patients with transrectal ultrasound were done,comparing the difference between the two groups in the echo level (hypoechogenic),outlines (ill-defined margin),posterior acoustic attenuation,periphery halo,microcalcification incidence,the blood supply level,peak systolic velocity (Vs) and resistance index (RI).Results:The ratios of hypoechogenic lesions in the prostate cancer group and prostatic hyperplasia group were 56.76% and 35.90%,respectively (P<0.05),the ratios of irregular outlines were 85.14% and 15.38% respectively (P<0.05),the ratios of microcalcification were 39.19% and 10.26%,respectively (P < 0.05),the ratios of posterior acoustic attenuation were 41.89% and 12.82%,respectively (P<0.05),and the ratios of periphery halo were 35.14% and 38.46% respectively (P>0.05).Vs of the two groups were (44.00 ± 15.30) cm/s and (17.32 ± 4.65) cm/s,respectively (P<0.05).RI of the two groups were 0.76 ± 0.10,and 0.51 ± 0.03 respectively (P<0.05).The significant correlation was designated in the blood supply level between the prostate cancer group and prostatic hyperplasia group (r=-0.388,P<0.01).Higher revascularization grade was seen in the prostate cancer group compared to benign prostatic hyperplasia group.Conclusion:(1) The significant roles for diagnosing prostate cancer are hypoechogenic,irregular outlines,spiculation,microcalcification,high revascularization grade,posterior acoustic attenuation,high Vs and high RI.(2) It could not help in diagnosing prostate cancer with ultrasonographic periphery halo or not.

经直肠超声联合血清EPCA-2、hK2对前列腺癌的早期诊断价值研究

目的探究经直肠超声联合血清早期前列腺癌抗原-2(EPCA-2)、己糖激酶-2(hK2)对前列腺癌的早期诊断价值。方法选取2022年6月至2023年12月在郑州大学第一附属医院确诊的98例前列腺癌患者作为试验组,另选取同期在本院确诊的72例前列腺增生患者为对照组。比较两组患者血清EPCA-2、hK2水平;ROC曲线分析经直肠超声联合血清EPCA-2、hK2对前列腺癌的诊断价值。结果与对照组相比,试验组的血清EPCA-2、hK2水平均明显升高(P<0.05);血清EPCA-2、hK2水平对前列腺癌早期诊断的曲线下面积(AUC)分别为0.845、0.869;经直肠超声对前列腺癌早期诊断的AUC为0.836,三者联合诊断的AUC为0.870。结论前列腺癌患者血清EPCA-2、hK2水平均明显上调,经直肠超声联合血清EPCA-2、hK2对前列腺癌早期诊断的准确率明显高于血清EPCA-2、hK2单独诊断,具有更高的诊断效能。

经直肠超声造影评估前列腺癌新辅助内分泌治疗反应的价值

目的:探讨经直肠超声造影(contrast-enhanced transrectal ultrasound)时间-强度曲线(time-intensity curve,TIC)参数评估前列腺癌(prostate cancer,PCa)患者对新辅助内分泌治疗(neoadjuvant hormonal therapy,NHT)的反应程度。方法:纳入27例接受NHT的PCa患者的临床资料,根据术后病理学检查结果分为有效组(n=16)和无效组(n=11)。对比两组患者临床病理学特征、治疗前后血清前列腺特异性抗原(prostate-specific antigen,PSA)和CETRUS检查指标及其变化率,以筛选与NHT反应性有关的潜在指标。进一步采用相关性分析评价其在评估患者对NHT反应方面的价值。结果:有效组和无效组在临床病理学特征、治疗前的血清PSA和C E T R U S检查指标方面的差异无统计学意义(均P>0.05)。治疗后,仅有效组的TIC曲线下面积(area under curve,AUC)低于无效组(560 dB·s vs 710 dB·s),其变化率大于无效组(-27.1%vs-5.3%)(均P<0.05)。相关性分析显示AUC变化率与组织学反应评分之间的相关性略高于治疗后AUC(r为-0.690 vs-0.630)。结论:CETRUS TIC参数中,NHT后的AUC及其变化率在评估PCa患者对NHT反应方面具有较好的价值。其中,AUC变化率可能与治疗反应程度更相关。

超微血管成像技术与多参数磁共振检查在前列腺癌诊断中的应用价值比较

目的:比较超微血管成像(SMI)技术与多参数磁共振(mpMRI)检查对前列腺癌的诊断准确性。方法:选取2022年1月—2023年11月上海市浦东新区人民医院收治的61例可疑前列腺癌患者,均行SMI和mpMRI检查以及经直肠超声(TRUS)引导的系统穿刺+可疑病灶的靶向穿刺活检术,以病理结果为金标准,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),评估SMI、mpMRI及SMI联合mpMRI诊断前列腺癌的准确率。结果:61例疑似前列腺癌患者中,病理诊断为前列腺腺癌22例,良性39例。SMI检出23例有异常征象,其中17例病理诊断为恶性,SMI诊断前列腺癌的灵敏度为77.27%、特异度84.62%、阳性预测值73.91%、阴性预测值86.84%、准确率81.97%。mpMRI检出24例有异常征象,其中20例病理诊断为恶性,mpMRI诊断前列腺癌的灵敏度为90.91%、特异度为89.74%、阳性预测值83.33%、阴性预测值94.59%、准确率90.16%。SMI联合mpMRI诊断前列腺癌的灵敏度为95.45%、特异度为79.49%、阳性预测值72.41%、阴性预测值96.88%、准确率85.25%。ROC曲线分析结果显示,SMI、mpMRI及SMI联合mpMRI诊断前列腺癌的AUC分别为0.809(95%CI:0.688~0.931)、0.903(95%CI:0.814~0.993)及0.875(95%CI:0.782~0.968),3种诊断方法比较差异无统计学意义(SMI vs mpMRI,Z=-1.591、P=0.112,SMI vs SMI联合mpMRI,Z=-1.427、P=0.153,mpMRI vs SMI联合mpMRI,Z=0.852、P=0.394)。结论:mpMRI诊断前列腺癌的准确率高于SMI,两者联合应用并精准靶向穿刺可提高前列腺癌的检出率。

麦默通与Tru-cut活检针对乳腺肿块活检的对比分析

目的:比较超声引导下麦默通与Tru-cut活检针在乳腺肿块微创活检诊断中的价值。方法:将214例乳腺肿块患者分为麦默通与Tru-cut活检针2组,在超声引导下进行微创活检,比较其取材成功率及病检符合率。结果:麦默通组与活检针组取材成功率分别为100%和90%,病检符合率分别为98.7%和90%,两组比较差异有统计学意义(P<0.05)。结论:超声引导麦默通微创穿刺乳腺肿块活检优于Tru-cut活检针,是目前病理活检诊断乳腺病变比较理想的取样方法。