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目的研究前列腺核磁共振成像(MRI)联合前列腺特异性抗原密度(PSAD)对前列腺癌(PCa)和前列腺增生(BPH)的诊断价值。方法 81例有穿刺活检或手术病理结果的前列腺病例,经穿刺或手术病理确诊28例为前列腺癌患者,53例为前列腺增生患者,回顾分析其资料,收集患者MRI的诊断结果、前列腺特异性抗原(PSA)数值及测量前列腺体积,结合PSA数值及前列腺体积,计算出PSAD,分别分析前列腺MRI及PSAD诊断结果及当MRI诊断不明时,联合PSAD的诊断结果。结果 MRI对前列腺癌和前列腺增生的诊断准确率分别为90.0%(18/20)、96.0%(24/25);PSAD对前列腺癌和前列腺增生的诊断准确率分别为68.0%(17/25)、80.4%(45/56);当MRI诊断不明确时,联合PSAD,前列腺癌阴性诊断率为78.6%(22/28)。结论联合MRI和PSAD可以明显提高前列腺癌和前列腺增生的诊断水平。
Objective To investigate the diagnostic value of prostatic magnetic resonance imaging (MRI) combined with prostate specific antigen density (PSAD) in prostate cancer (PCa) and benign prostatic hyperplasia (BPH). Methods Seventy-eight cases of prostatic adenocarcinoma with needle biopsy or surgical pathology were diagnosed as prostate cancer by puncture or pathology. Fifty-three patients with prostatic hyperplasia were retrospectively analyzed. The diagnostic results of MRI, prostate-specific antigen (PSA), prostate volume measurement, PSA value and prostate volume were calculated to calculate PSAD. The diagnostic results of MRI and PSAD were analyzed respectively. The results of combined diagnosis of PSAD with MRI diagnosis were unknown. Results The diagnostic accuracy rates of MRI for prostate cancer and benign prostatic hyperplasia were 90.0% (18/20) and 96.0% (24/25), respectively. The diagnostic accuracy rates of PSAD for prostate cancer and benign prostatic hyperplasia were 68.0% (17/25) , 80.4% (45/56). When MRI diagnosis was not clear, combined with PSAD, the negative diagnosis rate of prostate cancer was 78.6% (22/28). Conclusion The combination of MRI and PSAD can significantly improve the diagnosis of prostate cancer and benign prostatic hyperplasia.