前列腺靶向穿刺核心区域的影像特征分析

林国文; 戴波; 叶定伟; 朱耀; 秦晓健; 王弘恺

doi:10.13201/j.issn.1001-1420.2024.01.010

前列腺靶向穿刺核心区域的影像特征分析

- 复旦大学附属肿瘤医院泌尿外科复旦大学上海医学院肿瘤学系(上海，200032)
基金项目:
上海市医学创新研究专项基金(No：23Y11908800);上海市自然科学基金(No：21ZR1414500)

详细信息

通讯作者: 叶定伟，E-mail：dwyeli@163.com

中图分类号: R737.25

收稿日期: 2023-11-22

刊出日期: 2024-01-06

Imaging feature analysis of the core area in prostate targeted biopsy

- Department of Urology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China

More Information

Corresponding author: YE Dingwei, E-mail: dwyeli@163.com

Received Date: 22 November 2023

Publish Date: 06 January 2024

摘要

摘要: 目的分析多参数磁共振成像(multiparametric magnetic resonance imaging，mpMRI)和超声图像认知融合靶向穿刺的核心区域的影像特征。方法回顾性分析复旦大学附属肿瘤医院泌尿外科2022年1月—2023年10月实施前列腺认知融合靶向穿刺联合系统穿刺的255例患者临床资料。对比同期531例仅行系统穿刺患者，探讨前列腺癌及临床有意义前列腺癌(clinically significant prostate cancer，csPCa)的检出率，分析靶向穿刺的核心区域在mpMRI及超声图像上的影像特征。结果靶向穿刺联合系统穿刺组和仅系统穿刺组患者前列腺癌检出率分别为82.0%(209/255)和44.1%(234/531)，csPCa检出率分别为65.5%(167/255)和32.6%(173/531)，2组患者前列腺癌检出率和csPCa检出率比较差异均有统计学意义(P < 0.05)。靶向穿刺核心区域在磁共振图像上有4种不同的形态特征，分别为不规则形、类椭圆形、类圆形和弯月形，占比分别为60.0%(153/255)、18.0%(46/255)、12.2%(31/255)和9.8%(25/255)，且不规则形患者的血前列腺特异性抗原(prostate specific antigen，PSA)高于其他3种(P=0.001)。核心区域超声图像形态类似磁共振图像，但边缘较为模糊，且回声性质为低回声区的占比79.6%(203/255)，其余为等回声或高回声区。结论正确理解前列腺磁共振图像信息以及对靶向穿刺核心区域影像特征的把握，是成功进行前列腺靶向穿刺的关键所在。
- 前列腺癌 /
- 靶向穿刺 /
- 认知融合 /
- 影像特征
Abstract: Objective To analyze the imaging features of the core area in cognitive fusion targeted biopsy using mpMRI and ultrasound images.Methods A retrospective analysis was conducted on the clinical data of 255 patients who underwent prostate cognitive fusion targeted biopsy with a combined system at the Urology Department of Fudan University Shanghai Cancer Center from January 2022 to October 2023. Compared with 531 patients who underwent only systematic biopsy during the same period, the detection rates of prostate cancer and clinically significant prostate cancer(csPCa) were explored, and the morphological characteristics of the core area in targeted biopsy on mpMRI and ultrasound images were evaluated and analyzed.Results The detection rates of prostate cancer in the targeted biopsy combined with systematic biopsy group and the systematic biopsy-only group were 82.0%(209/255) and 44.1%(234/531) respectively, and the csPCa detection rates were 65.5%(167/255) and 32.6%(173/531) respectively, with statistically significant differences in the detection rates of prostate cancer and csPCa between the two groups(P < 0.05). There were four different morphological characteristics of the targeted biopsy core area in MRI images: irregular, ellipsoid-like, round-like, and crescent, accounting for 60.0%(153/255), 18.0%(46/255), 12.2%(31/255), and 9.8%(25/255) respectively, and the patients with irregular shape had higher blood PSA levels than the other three groups(P=0.001). The morphology of the core area in ultrasound images was similar to that in MRI images, but with more blurred edges, and the proportion of hypoechoic areas was 79.6%(203/255), with the rest being isoechoic or hyperechoic.Conclusion Correct understanding of prostate MRI image information and grasping the imaging features of the targeted biopsy core area are key to the successful performance of prostate targeted biopsy.
- prostate cancer /
- targeted biopsy /
- cognitive fusion /
- imaging features

HTML全文

图 1 核磁共振上靶向穿刺核心区域不同的影像形态特征

下载: 全尺寸图片幻灯片

表 1 2组的基线资料比较 M(P₂₅，P₇₅)

项目	靶向穿刺联合系统穿刺组(255例)	系统穿刺组(531例)	U	P值
年龄/岁	69.0(66.0，73.0)	68.0(62.0，82.0)	47 143.0	0.005
PSA/(ng/mL)	12.4(6.9，33.7)	9.39(5.6，23.1)	64 453.5	< 0.001
前列腺体积/mL	35.4(30.0，45.5)	33.8(31.5，52.1)	42 662.0	0.051
f/tPSA	0.12(0.11，0.15)	0.17(0.15，0.19)	53 217.0	< 0.001

下载: 导出CSV

表 2 2组的穿刺病理结果比较例(%)

组别	前列腺癌	csPCa
靶向穿刺联合系统穿刺组(255例)	209(82.0)	167(65.5)
系统穿刺组(531例)	234(44.1)	173(32.6)
χ²	120.3	141.7
P值	< 0.001	< 0.001

下载: 导出CSV

表 3 靶向穿刺核心区域影像特征例(%)，M(P₂₅，P₇₅)

项目	mpMRI图像上的形态特征				F	P值
项目	不规则形	类椭圆形	类圆形	弯月形	F	P值
例数	153(60.0)	46(18.0)	31(12.2)	25(9.8)	15.978	0.001
PSA/(ng/mL)	56.8(10.0，67.5)	25.5(7.5，40.2)	28.4(8.5，32.8)	13.8(7.0，19.7)	15.978	0.001

下载: 导出CSV

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