重点穿刺MRI可疑病灶区域在MRI/TRUS融合成像引导靶向前列腺穿刺中的诊断价值

来源 :中华男科学杂志 | 被引量 : 0次 | 上传用户:king_casper
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的:对于磁共振发现可疑病灶的患者,采取以穿刺可疑病灶区域为主,系统穿刺为辅的前列腺穿刺活检策略。探讨在保持总穿刺针数相对固定的前提下,通过重点穿刺磁共振可疑病灶来提高前列腺癌检出率的方法。方法:选取多参数磁共振发现的可疑前列腺癌患者461例,回顾分析其中多参数MRI可疑病灶均为单个,10μg/L≤PSA<20μg/L的患者262例。所有患者均采用MRI/TRUS融合成像引导靶向穿刺的方法。其中采取“6X+6”穿刺法的患者134例,常规“12+2X”法穿刺128例。“6X+6”穿刺法:采取以穿刺MRI可疑区域为主,随机穿刺为辅的策略,对于MRI可疑病灶区域重点穿刺6针,其余部位系统穿刺6针。常规“12+2X”穿刺法:即系统穿刺12针,可疑部位穿刺2针。比较两组穿刺活检的可疑病灶前列腺癌检出率,总前列腺癌检出率,以及并发症差异。分析可疑病灶的PI-RADS评分值,分布部位,横截面积以及直径等参数。分析各组前列腺癌穿刺阳性者Gleason评分的分布情况。结果:“6X+6”穿刺组与“12+2X”穿刺组的总前列腺癌检出率分别为44.8%与37.5%,两组中可疑病灶检出的前列腺癌占总前列腺癌的比例分别为37.3%与27.3%。“6X+6”穿刺组的这两项指标均高于“12+2X”穿刺组,两者差异均有统计学意义(P<0.05)。MRI可疑病灶分布部位以前列腺中部最多(45%)。横截面积为(0.48±0.11)cm~2,癌灶直径为(8.51±2.21)mm。穿刺结果显示,两组低级别肿瘤(Gleason3+3=6分)占多数,“6X+6”组为68%,“12+2X”组为71%。“12+2X”组有1例患者出现迷走神经反射,两组其余患者均可耐受局麻下的穿刺活检。两组穿刺后尿潴留、血尿、血便和发热等并发症均无统计学差异。结论:当多参数MRI发现可疑病灶时,在保持总穿刺针数一定的前提下,与传统“12+2X”穿刺法比较,采取重点穿刺MRI可疑病灶区域,以系统穿刺为辅的策略(“6X+6”穿刺法),可明显提高前列腺癌的检出率,穿刺后并发症发生率差异无统计学意义。 Objective: For patients with suspicious lesions found by magnetic resonance, a biopsy strategy of prostate biopsy based on punctured suspicious lesions and supplemented by systemic puncture is adopted. To explore the method of improving the detection rate of prostate cancer by focusing on the suspicious lesions of magnetic resonance on the premise of keeping the total number of puncturing needle fixed. Methods: A total of 461 suspicious prostate cancer patients were detected by multiparameter MRI. Among them, 262 patients with multi-parameter MRI suspicious lesions were all single and 10μg / L≤PSA <20μg / L were retrospectively analyzed. All patients used MRI / TRUS fusion imaging to guide the method of targeted puncture. Among them, 134 cases were treated by “6X + 6” puncture and 128 cases were punctured by conventional “12 + 2X” method. “6X + 6 ” puncture method: take the puncture of MRI suspicious area, random puncture supplemented by the strategy, the focus of MRI suspicious lesions puncture 6-pin, the rest of the system puncture 6-pin. Conventional “12 + 2X” puncture method: that is, the system puncture 12-pin, suspicious parts puncture 2-pin. Prostate cancer detection rate, total prostate cancer detection rate, and complications were compared between two groups of biopsy specimens. PI-RADS scores, distribution sites, cross-sectional area and diameter of suspicious lesions were analyzed. The distribution of Gleason score in each group of prostatic cancer positive patients was analyzed. Results: The detection rates of total prostate cancer in “6X + 6” puncture group and “12 + 2X” puncture group were 44.8% and 37.5% respectively. The total number of prostate cancer detected by suspicious lesions in both groups was The proportions were 37.3% and 27.3% respectively. The “6X + 6” puncture group was higher than those of the “12 + 2X” puncture group, both of which were statistically significant (P <0.05). Suspected lesions of MRI distribution in the middle part of the largest prostate (45%). The cross-sectional area was (0.48 ± 0.11) cm ~ 2 and the diameter of the tumor was (8.51 ± 2.21) mm. The puncture results showed that the two groups of low-grade tumors (Gleason3 + 3 = 6) accounted for the majority, 68% in the “6X + 6” group and 71% in the “12 + 2X” group. One patient in the “12 + 2X” group had vagal reflexes and the remaining patients in both groups were able to tolerate the biopsy under local anesthesia. There was no significant difference in urinary retention, hematuria, bloody stools and fever in two groups after puncture. Conclusion: When multi-parameter MRI found suspicious lesions, while maintaining the total number of puncturing needle under the premise, compared with traditional “12 + 2X” puncture method, take the focus of punctured MRI suspicious lesion area, supplemented by the system puncture Strategy ( “6X + 6 ” puncture), can significantly improve the detection rate of prostate cancer, postoperative puncture rate of complications was not statistically significant.
其他文献
礼堂,本该是行礼如仪的场所,但对很多中国人来说,它更是一个装满记忆的地方。对于“泛政治”的中国而言,礼堂首先是开会的地方——尤其是开大会统一思想的地方。这个政治仪式
论可持续发展对我国法制建设的影响(下)蔡守秋三、可持续发展对法制建设的影响可持续发展对法制建设的影响,包括可持续发展的运动(实践)和思想(理论)对法制实践和法学理论的冲击和挑
邓小平的民主与法制思想是马克思列宁主义、毛泽东思想的继承和发展.邓小平在谈到自己的理论与马列主义、毛泽东思想的关系时曾多次指出:“从许多方面来说,现在我们还是把毛
简介南汇区青少年科技艺术指导中心是南汇区教育局的直属单位。它承担着对全区中小幼科技艺术文化活动的组织管理、策划指导和培训服务任务。中心本着“让每一个学生都能获得
今年5月,内邱“牛郎织女传说”,被列入《河北省第一批省级非物质文化遗产名录》中,“七夕文化”受到空前的重视。内邱“牛郎织女”七夕文化,历史悠久,不仅至今流传着牛郎织女
无论是作为教育家,还是思想家,孔子都是一个有缺陷的人,他的学说,只能是也必定是中国“百家争鸣”文化中的“一家之言”。近些年来,关于孔子的话题又开始在文化界和中国人之
随着土壤、大气、水体面临的生态危机日益严重,我国现代农业问题越来越凸显。腐植酸能改良土壤、增进肥效、改善作物品质、修复重金属污染、提高作物抗逆性、调节作物生长,为
《西班牙1978年宪法》中的民族和地方自治条款朱伦节译第1条1西班牙是一个权利社会化和民主的国家,把自由、正义、平等和政治多元主义当作国家法律秩序的最高价值加以捍卫。2国家
从小就特别热爱科学,做着飞天梦的我,那回,从电视里收看到“神六”飞天的激动人心的场面,我的心情难以言表。特别是看到演播室主持人敬一丹说“当我们面对神舟六号发回的图像
法律规范是法律的本体和它的极为重要的特征,可以说,没有法律规范的存在,就没有法律可言。当然,在不同的法系的国家中,法律规范的表现形式或者说法律渊源方面是有较为明显的差别的