超声多模态影像诊断前列腺癌及指导经直肠超声引导下靶向穿刺

目的 观察超声多模态影像诊断前列腺癌(PC)及指导经直肠超声(TRUS)引导下靶向穿刺的价值。方法 收集128例前列腺病变患者，包括61例PC及67例良性病变；根据前列腺影像报告和数据系统(PI-RADS)将其分为A组(PI-RADS 3分，n=64)、B组(PI-RADS 4分，n=29)及C组(PI-RADS 5分，n=35),观察TRUS、经直肠实时弹性成像(TRTE)及经直肠超声造影(TR-CEUS)联合诊断PC的效能，分析其用于TRUS引导下靶向穿刺的价值。结果 以TRUS、TRTE及TR-CEUS中存在任意2项阳性结果为截断值，超声多模态影像诊断PC的准确率、敏感度、特异度、阳性预测值、阴性预测值及曲线下面积分别为73.44%、77.05%、70.15%、70.15%、77.05%及0.766[95%CI(0.686,0.845)]。随病灶PI-RADS得分升高，超声多模态影像诊断PC的敏感度呈大致下降、而特异度呈上升趋势。结论 超声多模态影像有助于诊断PC及制定穿刺活检策略。

Ultrasound multimodal imaging for diagnosis of prostate cancer and guiding transrectal ultrasound-guided targeted puncture

Objective To observe the value of ultrasound multimodal imaging for diagnosis of prostate cancer (PC) and guiding transrectal ultrasound (TRUS)-guided targeted puncture. Methods Totally 128 patients with prostate diseases were enrolled, including 61 cases of PC and 67 cases of benign diseases. According to prostate imaging reporting and data system (PI-RADS), the patients were divided into group A (PI-RADS 3 points, n=64), group B (PI-RADS 4 points, n=29) and group C (PI-RADS 5 points, n=35). The efficacy of the combination of TRUS, transrectal real-time elastography (TRTE) and transrectal contrast-enhanced ultrasound (TR-CEUS) for diagnosis of PC was observed, and its value for guiding TRUS-guided targeted puncture was analyzed. Results Taken any 2 positive results among TRUS, TRTE and TR-CEUS as the cut-off value, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) of ultrasound multimodal imaging for diagnosis of PC was 73.44%, 77.05%, 70.15%, 70.15%, 77.05% and 0.766 [95%CI(0.686, 0.845)], respectively. With the increase of PI-RADS score, the sensitivity of ultrasound multimodal imaging for diagnosis diagnosing PC showed a general downward trend, while its specificity showed an upward trend. Conclusion Ultrasound multimodal imaging was valuable for diagnosing PC and guiding TRUS-guided targeted puncture.