多参数引导下经直肠前列腺穿刺活检的应用价值

目的探讨多参数引导下经直肠前列腺穿刺,包括TRUS单参数,TRUS+弹性成像双参数,TRUS+弹性成像+MRI图像三参数超声引导下的穿刺,在前列腺癌诊断中的价值比较。方法回顾性分析我院接受前列腺手术患者186例,其中65例患者行TRUS单参数超声引导下的12点系统穿刺活检,68例行TRUS+经直肠弹性成像双参数超声引导下穿刺活检,53例行TRUS+弹性成像+MRI图像三参数超声引导下穿刺活检。对穿刺结果对比分析。结果经手术病理证实,186个患者中前列腺癌有90例,病理为腺癌,前列腺增生有96例。(1)TRUS单参数引导下的12点系统穿刺65例,其中穿刺病理为前列腺癌有21例,手术病理结果证实为前列腺癌有31例。穿刺阳性率为67.7%,与手术病理符合率为84.6%。(2)TRUS+弹性成像双参数引导下穿刺组共68例,其中穿刺病理为前列腺癌有28例,手术病理结果证实前列腺癌有33例,穿刺阳性率为84.8%,与手术病理符合率为92.6%。(3)TRUS+弹性成像+MRI图像三参数超声引导下穿刺组53例,其中穿刺病理为前列腺癌有25例,手术病理结果证实26例为前列腺癌,穿刺阳性率为96.2%,手术病理符合率为98.1%。结论TRUS+弹性成像+MRI图像三参数超声引导下的前列腺穿刺活检在前列腺癌的早期筛查中阳性率及手术病理符合率为三种检查方法中最高的,表明多参数引导下的前列腺穿刺具有较高的临床应用价值。

Application Value of Transrectal Elastic Imaging Combined with MRI in Prostate Biopsies

Objective To explore the value of multi-parameter guided transrectal prostate puncture,including TRUS single-parameter,TRUS elastic imaging double-parameter,TRUS elastic imaging MRI image three-parameter ultrasound-guided puncture in the diagnosis of prostate cancer.Methods Retrospective analysis of 186 patients undergoing prostate surgery in our hospital,of which 65 patients underwent TRUS 12-point systematic puncture guided by single-parameter ultrasound,68 TRUS transrectal elastography with double-parameter ultrasound guided puncture biopsy,and 53 TRUS elastography MRI image with three-parameter ultrasound guided puncture biopsy.The results of puncture were compared and analyzed.Results The surgical pathology confirmed that 90 of the 186 patients had prostate cancer,the pathology was adenocarcinoma,and there were 96 cases of prostatic hyperplasia.(1)TRUS single-parameter guided 12-point systematic puncture in 65 cases,of which the puncture pathology was prostate cancer in 21 cases,and the surgical pathological results confirmed that there were 31 cases of prostate cancer.The positive puncture rate was 67.7%,and the coincidence rate was 84.6%.(2)A total of 68 patients TRUS the two-parameter guided puncture group with elastography showed 28 cases of prostate cancer,33 cases confirmed by surgical pathology,84.8%positive puncture rate and 92.6%coincidence rate with surgical pathology.(3)TRUS elastography MRI three-parameter ultrasound-guided puncture group 53 cases,including 25 cases of prostate cancer puncture pathology,surgical pathological results confirmed 26 cases of prostate cancer,puncture positive rate of 96.2%,surgical pathology coincidence rate of 98.1%.Conclusions TRUS elastography MRI image three-parameter ultrasound-guided prostate biopsy in the early screening of prostate cancer positive rate and surgical pathological coincidence rate is the highest of the three methods,indicating that multi-parameter guided prostate puncture has a high clinical value.