【摘要】 目的探讨经直肠实时组织弹性成像(TRTE)联合多参数磁共振成像(MRI)引导前列腺靶向穿刺活检的价值。方法 2013年12月至2015年12月嘉兴市中医医院收治的疑诊前列腺癌患者105例。所有患者均经手术病理证实。105例患者分别行TRTE和MRI检查后,行经直肠超声引导下穿刺活检。穿刺采用常规6点穿刺活检和上述检查阳性征象部位针对性靶向活检。以手术病理结果作为金标准,计算TRTE、MRI、TRTE联合MRI引导穿刺活检诊断前列腺癌的敏感度、特异度、准确性、阳性预测值、阴性预测值。结果手术病理证实,本组105例患者中,前列腺良性结节44例,前列腺癌61例。前列腺癌56例。TRTE诊断为前列腺癌的52例中,手术病理证实45例。MRI诊断为前列腺癌的56例中,手术病理证实48例。TRTE、MRI及TRTE联合MRI引导穿刺活检诊断前列腺癌的敏感度、特异度、准确性、阳性预测值、阴性预测值分别为71.4%、84.0%、78.0%、0.865、0.698,78.6%、81.8%、80.0%、0.857、0.734,90.1%、88.6%、89.5%、0.916、0.866。TRTE联合MRI引导穿刺活检诊断前列腺癌的敏感度、特异度、准确性、阳性预测值、阴性预测值均高于TRTE及MRI。结论 TRTE和MRI均有各自的优势。穿刺前的精准定位,有助于制定前列腺穿刺个性化方案,二者联合应用可提高前列腺癌的检出率。更多还原

【Abstract】 Objective To evaluate the value of transrectal real-time tissue elastography(TRTE) combined with multi parameter magnetic resonance imaging(MRI) in prostate biopsy. Methods One hundred and five patients of suspected prostate cancer patients were treated from December 2013 to December 2015 in Jiaxing Traditional Chinese Medicine Hospital. All the patients were confirmed by operation and pathology. Transrectal ultrasonography guided biopsy was performed in 105 patients after TRTE and MRI examinations, respectively, including routine 6 point needle biopsy and targeted biopsy of the positive area. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TRTE, MRI and TRTE combined with MRI guided biopsy in the diagnosis of prostate cancer were evaluated with the results of operation and pathology as the gold standard. Results Surgical pathology confirmed that there were 44 benign prostatic nodules and 61 cases of prostate cancer in 105 cases. Fifty-two cases of prostate cancer was diagnosed by TRTE, and 45 cases were confirmed by operation and pathology. Fifty-six cases of prostate cancer was diagnosed by MRI, and 48 cases were confirmed by operation and pathology. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of diagnosing prostate cancer by TRTE, MRI and TRTE combined with MRI guided percutaneous biopsy were 71.4%, 84.0%, 78.0%, 0.865, 0.698, 78.6%, 81.8%, 80.0%, 0.857, 0.734, 90.1%, 88.6%, 89.5%,0. 916 and 0.866. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of diagnosing prostate cancer by TRTE combined with MRI guided biopsy were higher than those of TRTE and MRI. Conclusions Both TRTE and MRI have their respective advantages. The accurate localization before puncture is helpful to develop individualized program for prostate puncture, and the combining use of the two methods can improve the detection rate of prostate cancer.更多还原