学术论文

      前列腺癌骨及精囊转移的MRI诊断研究

      MRI diagnosis of bone and seminal vesicle metastasis in prostate cancer

      摘要:
      目的:分析MRI(磁共振成像)在诊断前列腺癌骨及精囊转移的临床价值,以期找到更为准确可靠地诊断前列腺癌骨转移和精囊转移的诊断方法,为前列腺癌患者的精准治疗提供可靠数据支持.方法:选择2015年10月至2016年5月我院收治的前列腺癌患者68例,所有患者均采用全身核素骨显像(骨扫描)检查,符合穿刺活检指征.穿刺活检前行MRI前列腺及周围组织、盆腔、脊柱扫描检查,最后行前列腺系统性穿刺活检.以前列腺系统行穿刺活检及骨穿刺活检为金标准,分析MRI扫描检查诊断前列腺癌骨及精囊转移的准确性、特异性和灵敏度.结果:穿刺活检共诊断出前列腺癌骨转移10例、精囊转移8例,共17例前列腺癌患者发生转移;MRI诊断出骨转移11例,精囊转移10例.MRI诊断前列腺癌骨转移和精囊转移的灵敏度为76.19%,特异度为95.74%,准确度为89.71%.结论:MRI对于前列腺癌患者骨转移和精囊转移阳性患者,结合穿刺活检,降低前列腺癌患者行前列腺系统穿刺检查和骨穿刺活检的有效性,降低患者实施无谓穿刺活检的几率,提高诊断的精准度.
      Abstract:
      Objectives:To analyze the clinical value of MRI in the diagnosis of bone and seminal vesicle metastasis in prostate cancer,in order to find a more accurate and reliable diagnostic method for the diagnosis of prostate cancer with bone metastasis and seminal vesicle metastasis,and to provide reliable data support for the accurate treatment of patients with prostate cancer.Methods:68 patients with prostate cancer in our hospital from October 2015 to May 2016 were selected.All patients were examined by radionuclide bone scan.MRI prostate and peripheral tissue,pelvic cavity and spine scan were performed before and at the end of the biopsy.The accuracy,specificity and sensitivity of MRI scan in the diagnosis of prostate cancer bone and seminal vesicle metastasis were analyzed by using prostate biopsy and bone biopsy as gold standard.Results:A total of 10 cases of prostate cancer bone metastasis,8 cases of seminal vesicle metastasis and 17 cases of prostate cancer patients were diagnosed.11 cases of bone metastasis and 10 cases of seminal vesicle metastasis were diagnosed by MRI.The sensitivity of MRI in the diagnosis of prostate cancer bone metastasis and seminal vesicle metastasis was 76.19%,the specificity was 95.74% and the accuracy was 89.71%.Conclusion:For prostate cancer patients with bone metastasis and seminal vesicle metastasis,MRI combined with biopsy can reduce the effectiveness of prostate cancer patients who has underwent prostate biopsy and bone biopsy system,reduce the risk of patients with unnecessary biopsy and improve the diagnosis accuracy.
      作者: 王润强 [1] 涂文彬 [1] 张海莲 [1] 朱友义 [2] 李天云 [3] 章军建 [4]
      Author: WANG Runqiang [1] TU Wenbin [1] ZHANG Hailian [1] ZHU Youyi [2] LI Tianyun [3] ZHANG Junjian [4]
      作者单位: 青海省第五人民医院影像科,西宁,810000 青海省心脑血管病医院影像科,西宁,810000 第四军医大学西京医院影像科,西安,710000 武汉大学中南医院,武汉,430071
      刊 名: 中国性科学 ISTIC
      年,卷(期): 2017, 26(11)
      分类号: R697+.3
      在线出版日期: 2017年12月22日
      基金项目: 湖北省卫生厅科研重点项目