【摘要】 目的分析前列腺特异抗原(PSA)不同区间内超声造影、增强MRI及其联合应用对前列腺癌的诊断价值。方法 132例疑似前列腺癌患者均行超声造影和增强MRI检查,并经直肠前列腺穿刺活检术证实。根据不同PSA分为3组:4.0 ng/ml≤PSA<10.0 ng/ml组54例,10.0 ng/ml≤PSA<20.0 ng/ml组40例,PSA≥20.0 ng/ml组38例,比较各组两种诊断方法及其联合应用对前列腺癌的诊断价值。结果 4.0 ng/ml≤PSA<10.0 ng/ml组中,超声造影、增强MRI及其联合应用诊断前列腺癌的特异性分别为82.00%、96.00%及80.00%,增强MRI与超声造影和联合应用的特异性比较差异均有统计学意义(均P<0.05)。10.0 ng/ml≤PSA<20.0 ng/ml组中,超声造影、增强MRI及其联合应用诊断前列腺癌的敏感性分别为42.86%、52.38%及80.95%,特异性分别为73.68%、68.42%及63.16%,二者联合应用与单一方法的诊断敏感性比较差异均有统计学意义(均P<0.05)。PSA≥20.0 ng/ml组中,32例前列腺癌,三种方法均准确诊断。结论前列腺癌患者为4.0 ng/ml≤PSA<10.0 ng/m时,增强MRI具有较高的诊断特异性,有诊断优势;为10.0 ng/ml≤PSA<20.0 ng/ml区间,超声造影和增强MRI联合应用具有较高的敏感性,具有诊断优势;PSA≥20.0 ng/ml时,超声造影检查简便,可提高前列腺穿刺活检的定位准确性,具有诊断优势。更多还原

【Abstract】 Objective To explore the value of contrast- enchanced ultrasound(CEUS),enhanced MRI and their combined application for prostate cancer detection in different area of prostate specific antigen(PSA). Methods One hundred and thirty-two patients with suspected prostate cancer were retrospectively analyzed,and all the patients underwent CEUS and enhanced MRI,they were verified by transrectal prostate biopsy.According to different area of PSA,the patients were divided into 3groups: 4.0 ng/ml≤PSA﹤10.0 ng/ml group(n=54), 10.0 ng/ml≤PSA﹤20.0 ng/ml group(n=40),PSA≥20.0 ng/ml group(n=38).The diagnostic value of different methods for prostate cancer were compared.Results In 4.0 ng/ml≤PSA﹤10.0 ng/ml group,the specificity of CEUS,MRI and the combined application were 82.00%,96.00%,80.00%,respectively. There were significant differences among CEUS,enhanced MRI and combined application in diagnosis of prostate cancer(all P<0.05). In 10.0 ng/ml≤PSA ﹤ 20.0 ng/ml group,the sensitivity of CEUS,enhanced MRI and combined application in diagnosis of prostate cancer were42.86%,52.38% and 80.95%,respectively,and the specificity were 73.68%,68.42% and 63.16%,respectively. There was significant difference between single method and combined application(P<0.05).In PSA≥20.0 ng/ml group,32 cases of prostate cancer were all diagnosed correctly with three kinds of methods. Conclusion When 4.0 ng/ml≤PSA﹤10.0 ng/ml,enhanced MRI has high specificity and advantage of diagnosis. When 10.0 ng/ml≤PSA﹤20.0 ng/ml,the combined application of CEUS and MRI has high sensitivity, and the combined application has the advantage of diagnosis. When PSA≥20.0 ng/ml,CEUS can improve the positioning accuracy of prostate biopsy,and has advantage of diagnosis.更多还原