系统活检联合超声造影及弹性成像靶向活检在前列腺活检中的应用价值

摘要 目的：探讨系统活检联合超声造影及弹性成像靶向活检在前列腺活检中的应用价值。方法：回顾性分析2015年1月至2019年12月我院收治的394例可疑前列腺癌患者的临床资料。分为前期组（2015年1月至2017年4月，采用12针系统活检法，共186例），和近期组（2017年5月至2019年12月，采用8针系统活检联合新技术（超声造影及弹性成像）靶向活检法，共208例）。前期组行12+X针系统穿刺活检。近期组患者先行彩虹灌注及实时弹性成像检查，确定可疑区域后，于该区域行靶向穿刺活检，然后行8针系统穿刺活检，有重复区域者适当减少穿刺针数。结果：近期组阳性患者99例；前期组阳性患者63例，前列腺癌检出率分别为47.6%（99/208）、33.87%（63/186），差异具有统计学意义（P<0.05）；近期组与前期组总穿刺针数分别为1929、2200针，近期组平均9.0 1.8针，前期组平均11.8 1.6针，差异具有统计学意义（P<0.05）；近期组与前期组穿刺针数阳性率分别为23.89%（461/1929）、11.82%（260/2200），差异具有统计学意义（P<0.05）；近期组与前期组并发症发生率分别为27.40%（57/208）、43.01%（80/186），差异具有统计学意义（P<0.05）。结论：系统活检联合超声造影及弹性成像靶向活检对前列腺癌具有较高应用价值。

The Application Value of Systematic Biopsy Combined with Contrast-Enhanced Ultrasound and Real-Time Tissue Elastographyin Prostate Biopsy

ABSTRACT Objective: To explore the clinical application of CEUS combined with real-time tissue elastography(RTE) targeted biopsy in prostate biopsy. Methods: The clinical data of 394 patients with suspected prostate cancer admitted to our hospital from January 2015 to December 2019 were retrospectively analyzed. It was divided into the early group (from January 2015 to April 2017, 12-needle systematic biopsy was adopted, total 186 cases) and the recent group (from May 2017 to December 2019, targeted biopsy was adopted by 8-needle systematic biopsy combined with new technology (contrast-enhanced ultrasound and elastography), total 208 cases. In the early group, 12+X needles aspiration biopsy was performed. In the recent group, rainbow perfusion and real-time tissue elastography were performed first. After the suspicious area was identified, targeted puncture biopsy was performed in that area, and then 8-needle systematic puncture biopsy was performed. There were repeated areas, and the number of puncture needles was appropriately reduced. Results: In the group, 99 patients were positive for prostate cancer. In the early group, there were 63 patients with positive prostate cancer. The detection rate was 47.6% (99/208) and 33.87% (63/186), respectively, with statistically significant differences (P<0.05). The number of needles in the recent group and the early group were 1,929 and 2,200, respectively. The average number of needles in the recent group and early group was 9.0 1.8 and 11.8 1.6. The positive rate of needle number was 23.89% (461/1929) and 11.82% (260/2200) in the recent group and the early group, respectively, with statistically significant difference (P<0.05). The complication rates of the recent group and the previous group were 27.40% (57/208) and 43.01% (80/186), respectively, with statistically significant differences (P<0.05). Conclusion: Systematic biopsy combined with CEUS and TRTE can improve the detection rate of prostate cancer.