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目的探讨超声造影引导减针在前列腺癌穿刺活检中的应用价值。方法回顾分析我院900例可疑前列腺癌(PCa)患者穿刺活检方法,其中548例行传统10点法(非造影组),另352例通过超声造影定位靶向病灶区,采用靶向穿刺替代部分传统穿刺点的穿刺方法 (造影组),所有病例均与病理结果进行对比分析。结果 900例患者中PCa共诊断362例(40.2%),非造影组检出率38.0%,造影组检出率43.8%,两组穿刺法PCa的检出率无统计学差异(P=0.084)。非造影组获取组织5 540条,其中癌组织392条,造影组获取组织2 764条,其中癌组织316条,造影组每次取材PCa的阳性率明显高于非造影组(11.4%vs 7.1%),二者差异有统计学意义(P<0.01)。非造影组并发症发生率高于造影组(24.5%vs 15.9%),差异有统计学意义(P=0.002)。结论与传统穿刺方法相比,超声造影减针穿刺在不降低前列腺癌检出率的情况下,减少了穿刺针数,并增加了每次取材诊断PCa阳性率,提高了穿刺活检效率。
Objective To investigate the value of contrast-enhanced ultrasound guided needle biopsy in prostate biopsy. Methods A retrospective analysis of 900 patients with PCa in our hospital was performed. Among them, 548 patients underwent traditional 10-point radiofrequency ablation (non-radiography), and 352 patients were targeted by ultrasound contrast. The targeted biopsy was replaced by targeted puncture Traditional puncture puncture method (contrast group), all cases were compared with the pathological results. Results There were 362 cases (40.2%) of PCa diagnosed in 900 patients, 38.0% in non-contrast group and 43.8% in contrast group. There was no significant difference in the detection rate of PCa between the two groups (P = 0.084) . In the non-imaging group, 5 540 tissues were obtained, of which 392 were cancer tissues, and 2 764 tissues were obtained from the contrast group. There were 316 cancer tissues. The positive rate of PCa in each imaging group was significantly higher than that in the non-imaging group (11.4% vs 7.1% ), The difference was statistically significant (P <0.01). The incidence of complications in non-contrast group was higher than that in contrast group (24.5% vs 15.9%), the difference was statistically significant (P = 0.002). Conclusion Compared with the traditional puncture method, CEA needle puncture does not reduce the detection rate of prostate cancer, reducing the number of puncturing needle, and increasing the positive rate of each diagnosis of PCa and improve the biopsy efficiency.