CAJ | 학술논문

目的探讨经直肠超声结合MRI在前列腺穿刺活检中对前列腺癌(PCa)的检出率.资料与方法168例疑似PCa患者于穿刺前行经直肠超声和MRI检查,超声与MRI医师共同分析图像,确定可疑病灶.如超声和MRI均未发现病灶,则行系统6针穿刺;如超声和(或)MRI发现病灶,则在病灶横切面与纵切面各取材1针,然后行系统6针穿刺.结合病理结果比较两种影像学检查及二者结合对PCa的检出率.结果168例患者中,69例为PCa,3例为前列腺上皮肉瘤变,96例为前列腺增生.52例PCa发生于外周腺,6例PCa为弥漫性病变,余11例为移行区肿瘤.穿刺活检前超声诊断PCa的灵敏度及特异度分别为74.0%、53.4%,MRI诊断PCa的灵敏度及特异度分别为80.4%、63.9%,二者联合诊断的灵敏度及特异度分别为84.5%、72.7%.结论经直肠超声结合MRI检查有助于提高PCa的检出率,特别是DWI序列有助于检出移行区PCa.
목적탐토경직장초성결합MRI재전렬선천자활검중대전렬선암(PCa)적검출솔.자료여방법168례의사PCa환자우천자전행경직장초성화MRI검사,초성여MRI의사공동분석도상,학정가의병조.여초성화MRI균미발현병조,칙행계통6침천자;여초성화(혹)MRI발현병조,칙재병조횡절면여종절면각취재1침,연후행계통6침천자.결합병리결과비교량충영상학검사급이자결합대PCa적검출솔.결과168례환자중,69례위PCa,3례위전렬선상피육류변,96례위전렬선증생.52례PCa발생우외주선,6례PCa위미만성병변,여11례위이행구종류.천자활검전초성진단PCa적령민도급특이도분별위74.0%、53.4%,MRI진단PCa적령민도급특이도분별위80.4%、63.9%,이자연합진단적령민도급특이도분별위84.5%、72.7%.결론경직장초성결합MRI검사유조우제고PCa적검출솔,특별시DWI서렬유조우검출이행구PCa.
Purpose To explore the diagnostic value of transrectal ultrasound combined with MRI for the detection rate of prostate cancer (PCa) in prostate biopsy. Materials and Methods Transrectal ultrasound and MRI were applied to 168 suspected patients with PCa before puncture, and ultrasound and MRI physician together analyzed the image to determine suspicious lesions. Neither ultrasound nor MRI found the lesion, systematic 6 cores prostate biopsy were used;either of the two imaging found the lesion, the biopsy should be contained puncture one core of both transverse section and longitudinal section of the lesion and then systematic 6 cores biopsy. PCa detection rate was compared for the transrectal ultrasound, MRI and transrectal ultrasound combined with MRI based on the pathological results. Results In the 168 patients, there were 69 cases of PCa (52 cases in peripheral gland, 6 cases in whole gland, and 11 cased in transitional region) and 99 cases of hyperplasia of prostate gland. Transrectal ultrasound combined with MRI before biopsy could effectively improve the sensitivity and specificity (84.5% and 72.7%) compared with transrectal ultrasound (74.0% and 53.4%) or MRI (80.4% and 63.9%) separately. Conclusion Transrectal ultrasound combined with MRI before biopsy is an effective method to improve the detection rate of PCa, and DWI sequence especially contributes to detect the prostate cancer in transitional zones.