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1.
PSA在前列腺癌诊断中的意义   总被引:1,自引:0,他引:1  
前列腺特异抗原(PSA)在对前列腺癌的诊断中日益受到临床的重视。我院自1994年5月开始对前列腺疾病患者血中PSA含量进行检测,现就具有完整资料的患者血清PSA含量与其临床意义分析如下。1资料与方法1.1一般资料本组共117例,年龄52~82岁,平均69.8岁。其中前列腺癌41例,前列腺增生症40例,正常对照组36例。前列腺癌标本均经手术或前列腺穿刺病理确诊。前列腺增生症均经手术后病理确诊。正常对照组为同年龄阶段正常健康体检者,B超和肛诊未发现前列腺疾病。前列腺癌患者中核素骨扫描显示骨转移14例,CT及MRI显示盆腔及髂血管淋巴…  相似文献   

2.
张华  方建华  包凌云  陈创华 《浙江临床医学》2023,(7):1051-1053+1057
目的 比较经直肠超声造影与磁共振检查对不同Gleason评分前列腺癌患者的诊断价值。方法 回顾性分析2021年1~10月309例临床疑似前列腺癌患者的临床资料,所有患者均行CEUS和MRI检查。根据穿刺病理Gleason评分将前列腺癌患者分为低危、中危、高危三组,比较CEUS与MR对各组的诊断效能。结果 CEUS与MR对前列腺癌诊断敏感度分别为75.3%、82.9%,特异度分别为69.9%、70.5%,准确度分别为72.5%、76.4%,差异无统计学意义(P>0.05)。低、中危组中,MR+CEUS检查对前列腺癌的阳性检出率高于CEUS、MR单独检查,差异有统计学意义(P<0.05),MR、CEUS单独使用时对前列腺癌的阳性检出率差异无统计学意义(P>0.05)。高危组中,CEUS+MR检查、MR检查、CEUS检查对前列腺癌阳性检出率比较差异无统计学意义(P>0.05)。结论 CEUS和MR对前列腺癌均具有较高的诊断价值,二者联合使用能提高中、低危患者的诊断效能。  相似文献   

3.
目的:探讨超声造影(CEUS)与磁共振动态增强成像(DCE-MRI)及其联合应用对前列腺癌的诊断价值。方法回顾性分析经系统穿刺活检术证实的75例前列腺疾病患者术前超声造影及MRI检查数据,结合病理组织学比较两种检查方法及其联合应用诊断前列腺癌的价值。结果 CEUS、DCE-MRI及二者联合对前列腺癌诊断的灵敏度分别为73.91%、82.61%和91.30%,特异度分别为76.92%、71.15%和57.69%,诊断准确率分别为76.92%、74.67%和68%,CEUS和DCE-MRI两种检查方法对前列腺癌的诊断价值差异无明显统计学差异(P>0.05);二者联合对前列腺癌诊断与单独应用一种诊断技术相比,差异均具统计学意义(P<0.05)。二者联合应用的ROC曲线下面积为0.921,高于单一检查的曲线下面积0.769(DCE-MRI)、0.754(CEUS),二者联合应用较单独应用一种具统计学意义(P<0.05)。结论 CEUS、DCE-MRI对前列腺癌的检测各具优势,两者的联合应用可有效提高诊断的灵敏度,为前列腺癌的检出提供有力支持。  相似文献   

4.
目的:探讨动态对比增强磁共振(DCE-MRI)联合前列腺特异性抗原(PSA)诊断前列腺癌的价值。方法:以我院2020年1月至2021年12月期间收治的118例疑似前列腺癌患者为研究对象,所有患者均接受DCE-MRI和PSA检查。以病理活检结果为金标准,对比前列腺癌患者中DCE-MRI各参数以及PSA水平,两种检查方式单独和联合检测与金标准的一致性以及对前列腺癌的诊断价值。结果:118例患者中,病理活检检测出恶性37例,检出率为37/118(31.36%),良性81例,检出率为81/118(68.64%);恶性患者中DCE-MRI各参数以及PSA水平均高于良性患者(P<0.05);DCE-MRI和PSA单独检测同金标准的一致性一般,Kappa值分别为0.554和0.433,DCE-MRI和PSA联合检测同金标准一致性较好,Kappa值为0.750;DCE-MRI和PSA联合检测的诊断价值高于单独检测。结论:DCE-MRI和PSA均可对前列腺癌进行诊断,但是联合检测诊断价值更高。  相似文献   

5.
目的:探讨MRI、磁共振弥散成像(DWI)联合前列腺特异抗原(PSA)诊断前列腺癌和良性前列腺增生(BPH)的价值。材料与方法:回顾性分析经手术病理证实或穿刺活检证实的16例前列腺癌和18例前列腺增生的患者,以上患者均进行了b值500,1000的DWI扫描,并均获得总前列腺特异抗原t PSA及游离f PSA数据。在MRI T2WI图像上观察前列腺的形态、病变位置、信号特点及肿瘤侵犯范围。测得16例PCa及18例BPH在b值1000的ADC值,并进行统计学分析。结果:16例Pca,14例位于周围带,2例同时累计周围带及中央带,T2WI表现为低信号结节影,3例合并耻骨及髂骨转移,在弥散序列上表现为片状高信号影。18例前列腺增生,15例位于CG,3例位于PZ。11例在T2WI序列表现为大小不等高低混杂信号影,7例在T2WI序列表现为中央带高信号结节。16例PCa平均ADC值1.52±0.32×10-3,18例BPH结节平均ADC值2.052±0.87×10-3两者之间差异有统计学意义(t=1.78,P=0.047),BPH以及PCa两组总PSA及t PSA/f PSA比值间均有统计学差异。结论:MRI、DWI联合PSA比值的测定可以明显提高PCa和BPH诊断准确率。  相似文献   

6.
目的  观察经直肠超声(TRUS)、磁共振动态增强扫描(DCE-MRI)联合血清前列腺特异性抗原(PSA)检测在前列腺肿瘤良恶性鉴别诊断中的应用价值。方法  选取2019年1月~2022年10月我院收治的前列腺肿瘤患者102例,对所有入选患者行TRUS及DCE-MRI检查,以穿刺活检诊断结果为金标准,观察良恶性前列腺肿瘤患者的血清PSA水平,并比较TRUS、DCE-MRI、PSA以及三者联合诊断对前列腺肿瘤良恶性鉴别的价值。结果  102例前列腺肿瘤患者中,经穿刺活检发现38例为恶性肿瘤,64例为良性肿瘤。采用TRUS鉴别前列腺肿瘤良恶性的敏感度、特异性及准确性分别为63.16%、76.56%及71.57%,DCE-MRI检查为73.68%、78.13%及76.47%,PSA检测为89.47%、70.31%及76.47%,且经穿刺活检诊断为恶性前列腺肿瘤的患者,PSA水平及DCE-MRI检查参数值均高于良性肿瘤患者(P<0.05)。三者联合检测的敏感度及准确性分别为97.37%、88.24%,高于单一检查方法(P<0.05)。结论  恶性前列腺肿瘤患者与良性患者相比,其血清PSA水平更高,采用TRUS、DCE-MRI及PSA三者联合检测的方法能显著提高前列腺肿瘤良恶性鉴别的诊断效能,值得推广。  相似文献   

7.
目的:探讨超声造影引导改良穿刺在低水平PSA(前列腺特异性抗原)前列腺癌诊断中的应用。方法:收集新疆医科大学附属肿瘤医院可疑前列腺癌的患者78例,血清PSA为4-20ng/mL,随机分为系统穿刺组(38例)和改良穿刺组(40例),系统穿刺组采用前列腺系统10点穿刺法,改良组采用超声造影引导前列腺靶向穿刺结合系统穿刺的改良10点穿刺法,所有穿刺标本送检,对照病理结果,分析比较两组对前列腺癌的检出率。结果:系统穿刺组检出前列腺癌9例,改良穿刺组检出前列腺癌18例,系统穿刺组检出阳性率为23.68%(9/38),改良穿刺组检出阳性率为45.00%(18/40),两组比较差异有统计学意义(χ2=3.912,P=0.048)。两组穿刺方法总穿刺针数为789针,系统穿刺组为386针,穿刺阳性针数为28针,系统穿刺组单针穿刺阳性率为7.25%(28/386);改良穿刺组为403针,穿刺阳性针数67针,改良穿刺组单针穿刺阳性率为16.63%(67/403),两组比较差异有统计学意义(χ2=16.349,P<0.001)。结论:超声造影引导改良穿刺在不增...  相似文献   

8.
【目的】探讨弥散加权成像(DWI)对前列腺癌的诊断价值以及其表现扩散系数(ADC)值与前列腺特异性抗原(PSA)的相关性。【方法】回顾性分析行前列腺磁共振成像(MRI)检查的24例前列腺癌患者,MRI检查包括常规MRI及DwI,评价前列腺癌病灶在DWI及ADC图上的可见性,测量前列腺癌灶的ADC值,并分析其与PSA的相关性。【结果】前列腺癌病灶在DwI上均表现为高信号,ADC图为低信号,其ADC值与PSA呈负相关。【结论IDWI对前列腺癌有重的诊断价值,在常规MRI基础上,结合DwI能提高对前列腺癌诊断的准确性;病灶ADC值的测量,有助于对前列腺癌的生物学特性的进一步评估。  相似文献   

9.
目的探讨ALP、PSA及其相关指标(fPSA、fPSA/tPSA、PSAD)与前列腺癌骨转移的关系,及对前列腺癌骨转移诊断的预测作用。方法回顾分析2005年9月至2009年2月在我院经前列腺穿刺活检或手术后病理检查确诊的167例前列腺癌患者。以ECT、X线片、CT/MRI或骨活检诊断骨转移,分析ALP、PSA、fPSA、fPSA/tPSA、PSAD与前列腺癌骨转移的关系及对骨转移的诊断价值。结果 167例前列腺癌患者中骨转移104例(62.3%),非骨转移63例(37.7%)。骨转移组ALP、PSA及PSAD明显高于非骨转移组(均P〈0.01),而两组间fPSA/tPSA差异无统计学意义(P〉0.05)。PSA〉50ng/ml组骨转移率明显高于PSA〉20~50ng/ml组、〉10~20ng/ml组和≤10ng/ml组(均P〈0.05);ALP〉90U/L组骨转移率明显高于ALP≤90U/L组(P〈0.05);PSAD〉0.4ng.ml-1.cm-3组骨转移率明显高于PSAD≤0.4ng.ml-1.cm-3组(P〈0.05)。以ALP〉90U/L、PSA〉50ng/ml和PSAD〉0.4ng.ml-1.cm-3为界分别分析ALP、PSA、PSAD、PSA+ALP、PSA+PSAD和PSA+PSAD+ALP对前列腺癌骨转移诊断的预测价值,发现指标联合应用后阳性预测值及阴性预测值较单一指标好,PSA+PSAD+ALP联合应用的敏感度、特异度、阳性预测值及阴性预测值最佳,分别为100%、79.17%、91.38%及100%。结论 ALP、PSA及PSAD均为判断前列腺癌患者有无骨转移的可靠指标,PSA+PSAD+ALP联合应用有助于预测前列腺癌骨转移,当患者PSA〈50ng/ml、PSAD〈0.4ng.ml-1.cm-3及ALP〈90U/L时,几乎可排除骨转移。  相似文献   

10.
目的:探讨超声引导下经会阴前列腺系统穿刺(transperineal prostate systematic biopsy,SPB)与认知融合多参数磁共振成像(multi-parameter magnetic resonance imaging,mpMRI)经会阴靶向穿刺(cognitive fusion mpMRI ...  相似文献   

11.
This retrospective study was designed to evaluate the value of contrast-enhanced harmonic ultrasonography (CEHU), diffusion-weighted magnetic resonance imaging (DW-MRI) and CEHU plus DW-MRI for the diagnosis of prostate transition-zone (TZ) cancer. In total, 31 TZ cancers in 28 patients and 25 peripheral zone (PZ) cancers in 21 patients without a TZ cancer were evaluated. All patients underwent DW-MRI and CEHU followed by radical prostatectomy. Predictors for the diagnosis of prostate cancer were evaluated in three protocols (CEHU, DW-MRI, CEHU plus DW-MRI). Statistical analysis of the differences between these protocols and receiver operating characteristic (ROC) curve analysis were carried out. CEHU plus DW-MRI had a significantly higher sensitivity, accuracy and negative-predictive value (90.3%, 73.2% and 81.3%, respectively) for TZ cancer than either method alone. The area under the ROC curve values were 0.659, 0.679 and 0.712 for CEHU, DW-MRI, and CEHU plus DW-MRI, respectively. In conclusion, CEHU plus DW-MRI might be a useful protocol for the detection and location of TZ cancer.  相似文献   

12.
ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.  相似文献   

13.
ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.  相似文献   

14.
ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.  相似文献   

15.
ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.  相似文献   

16.
ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.  相似文献   

17.
ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.  相似文献   

18.
ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.  相似文献   

19.
ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.  相似文献   

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