| 弹性成像联合磁共振动态增强检查对前列腺良恶性病变诊断的临床应用 |
| 投稿时间：2015-02-08 修订日期：2015-03-04 点此下载全文 |
| 引用本文：常莹,杨敬春,段祥攻.弹性成像联合磁共振动态增强检查对前列腺良恶性病变诊断的临床应用[J].医学研究杂志,2015,44(10):60-63 |
| DOI：
10.11969/j.issn.1673-548X.2015.10.017 |
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| 基金项目:北京市科委"首都临床特色应用研究"(Z141107002514060) |
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| 中文摘要:目的 评价经直肠超声弹性成像、磁共振动态增强及联合应用对前列腺良恶性病变诊断的临床应用。 方法 对60例血清PSA水平高于4.0ng/ml的男性(43~83岁,平均年龄71岁)分别行经直肠超声检查 (transrectal ultrasound,TRUS),经直肠实时组织超声弹性成像(transrectal real-time elastography,TRTE)及磁共振动态增强检查(dynamic contrast material-enhanced magnetic resonance imaging,DCE-MRI)。随后,对这些患者上述检查阳性征象部位针对性靶向活检,同时行常规6针活检,分别比较3种检查方法的前列腺癌阳性检出率。 结果 60例患者中23例为前列腺癌 (23/60,38.3%)。TRTE、DCE-MRI及两者联合对于诊断前列腺周缘区恶性病灶的敏感度、特异性及准确性分别为 73.9%、78.3%、87.0%,80.1%、75.1%、89.2%及78.3%、76.7%、88.3%。与TRUS比较,TRTE及DCE-MRI引导下的靶向穿刺活检提高前列腺癌的阳性检出率(P<0.05)。 结论 TRTE、DCE-MRI检查能够提高对血PSA升高患者前列腺癌病灶的检出率,从而提高前列腺穿刺活检的阳性率,为临床诊断提供强有力的诊断依据。 |
| 中文关键词:前列腺肿瘤 经直肠超声检查 弹性成像 磁共振成像 穿刺活检 |
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| Transrectal Real-time Elastography Combined with Dynamic Contrast Material-enhanced Magnetic Resonance Imaging for the Diagnosis of Benign and Malignant Prostate Lesions |
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| Abstract:Objective To compare the value of transrectal real-time elastography (TRTE) with dynamic contrast material-enhanced magnetic resonance imaging(DCE-MRI) for prostate cancer detection. Methods A total of 60 men (mean age 71years, range 43 to 83) with serum PSA levels of greater than 4.0ng/ml were assessed using gray-scale transrectal ultrasound(TRUS), transrectal real-time elastography(TRTE)and dynamic contrast material-enhanced magnetic resonance imaging(DCE-MRI). Subsequently, these patients underwent systematic sextant transrectal biopsy and additional biopsies for positive sites on gray-scale TRUS, TRTE and DCE-MRI. The cancer detection rates of the 3 techniques were compared. Results Cancer was detected in 23 of the 60 patients (23/60,38.3%). TRTE and DCE-MRI had a higher sensitivity, specificity and accuracy of 73.9%,78.3%,87.0%,80.1%,75.1%,89.2%,78.3%,76.7%,88.3% respectively. TRTE and DCE-MRI guided targeted biopsy improve the positive detection rate of prostate cancer, compared with TRUS (P<0.05). Conclusion TRTE and DCE-MRI can improve the detection rate of the increase of serum PSA in patients with prostate cancer, so as to improve the positive rate of prostate biopsy diagnosis,provide strong support for clinical diagnosis. |
| keywords:Prostate cancer Transrectal ultrasound Elastography Magnetic resonance imaging Biopsy |
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