CT与MRI认知融合影像在经腹会阴直肠切除术后患者经会阴前列腺靶向穿刺中的应用

目的 探究磁共振融合CT引导下经会阴前列腺靶向穿刺技术在无肛门患者中的应用。方法 对2例APR术后检查发现血清PSA异常升高的患者行磁共振融合CT引导下前列腺靶向穿刺技术。穿刺前先对2名患者进行多参数前列腺MRI,操作者通过目视估测,判断目标病灶位置。随后穿刺者对目测所得病灶靶向穿刺,其中患者1还进行了12针系统性穿刺,穿刺所取得的前列腺组织送病理检查,以病理结果为最终诊断。结果 患者1病理提示良性前列腺组织；患者2病理提示前列腺腺癌,Gleason评分3+4=7。结论 磁共振融合CT引导下经会阴前列腺靶向穿刺技术在无肛门患者中的应用是可行的,但这一技术的敏感性与特异性则有赖于进一步研究。

Application of computed tomography/magnetic resonance imaging cognitive fusion imaging in transperineal targeted prostate biopsy after abdominoperineal resection

Objective To explore the clinical application of multiparametric prostate magnetic resonance imaging(mpMRI) and cognitively targeted transperineal CT-guided biopsy in patients without rectal access. Methods We applied the targeted MRI/CT cognitively fusion prostate biopsy to detect prostate cancer in 2 patients who suffered from APR before with elevated serum PSA level. In both cases, a multiparametric prostate magnetic resonance imaging was performed to detect a suspicious lesion before biopsy. Image of mpMRI served as a cognitive map for CT-guided transperineal biopsy. In addition to the targeted biopsies, another systematic biopsy was implemented in patient 1. Specimens were sent to pathology laboratory, and pathologic findings were regarded as the final diagnosis. Results Pathological report of patient 1 showed benign prostate tissue, while the other showed prostate cancer, Gleason 7. Conclusion Multiparametric prostate magnetic resonance imaging(mpMRI) and cognitively targeted transperineal CT-guided biopsy are feasible in patients without rectal access, but the sensibility and specificity need further research.