【摘要】 目的探究MRI-超声认知融合在前列腺靶向穿刺活检中的应用价值。方法回顾性分析2019年1月至2022年9月我院收治的疑似前列腺癌患者290例,均进行MRI-超声认知融合下前列腺靶向穿刺和经直肠超声(TRUS)引导下系统穿刺,比较两种方法检出率、单针阳性率、Gleason评分差异,分析PIRADS评分与前列腺特异性抗原(PSA)的相关性。结果290例患者中,经病理确诊前列腺癌患者104例,MRI-超声认知融合前列腺靶向穿刺活检的检出率为79.81%,灵敏度为79.8 0%,特异度为84.94%,准确率为83.10%,kappa值为0.638;经直肠超声引导下系统穿刺活检的检出率为66.35%,灵敏度为56.73%,特异度为86.02%,准确率为75.52%,kappa值为0.445;MRI-超声认知融合前列腺靶向穿刺的单针阳性率高于TRUS引导系统穿刺(P<0.05),两种穿刺方法的Gleason评分差异有统计学意义(P<0.05);104例前列腺癌患者中,PI-RADS评分2分16例,3分62例,4分26例;Pearson相关性分析结果显示,前列腺癌患者PI-RADS评分与PSA水平、Gleason评分均呈正相关(P<0.05)。结论 MRI-超声认知融合前列腺靶向穿刺活检对前列腺癌的诊断价值优于TRUS引导下系统穿刺,值得推广应用。更多还原

【Abstract】 Objective To explore the application value of MRI-ultrasound cognitive fusion in prostate targeted puncture biopsy. Methods Retrospective analysis was performed on 290 patients with suspected prostate cancer admitted to the hospital from January 2019 to september 2022. Prostate targeted prostate puncture under MRI-ultrasound cognitive fusion and systematic puncture guided by transrectal ultrasound(TRUs) were performed, and the differences in detection rate of the two methods, single needle positive rate and Gleason score were compared, and the correlation between PI-RADs score and prostate specific antigen(Ps A) was analyzed. Results Among the 290 patients, 104 cases were pathologically diagnosed with prostate cancer. The detection rate was 79.81% of MRI-ultrasound cognitive fusion prostate targeted puncture biopsy and was 66.35% of transrectal ultrasound-guided systematic puncture biopsy respectively. The single needle positive rate of MRI-ultrasound cognitive fusion prostate targeted puncture was higher than that of TRUs-guided systematic puncture(P<0.05), and there was statistical difference in Gleason score between the two puncture methods(P<0.05). Among 104 patients with prostate cancer, there were 16 cases with PI-RADs score of 2 points, 62 cases with score of 3 points and 26 cases with score of 4 points. Pearson correlation analysis showed that PI-RADs score was positively correlated with Ps A level and Gleason score in patients with prostate cancer(P<0.05). Conclusion MRI-ultrasound cognitive fusion prostate targeted puncture biopsy has better diagnostic value on TRUs-guided systematic puncture in the diagnosis of prostate cancer, thus it is worthy of popularization and application.更多还原