經(jīng)直腸動(dòng)態(tài)三維超聲造影斷層成像在前列腺癌診斷及前列腺靶向穿刺中的應(yīng)用

經(jīng)直腸動(dòng)態(tài)三維超聲造影斷層成像在前列腺癌診斷及前列腺靶向穿刺中的應(yīng)用經(jīng)直腸動(dòng)態(tài)三維超聲造影斷層成像在前列腺癌診斷及前列腺靶向穿刺中的應(yīng)用

摘要：

目的：探討經(jīng)直腸動(dòng)態(tài)三維超聲造影斷層成像（3Dcontrast-enhancedtransrectalultrasoundimaging，3DCE-TRUS）在前列腺癌診斷及前列腺靶向穿刺中的應(yīng)用及價(jià)值。

方法：收集32例行經(jīng)直腸3DCE-TRUS檢查的前列腺癌病例進(jìn)行分析，采用斯皮爾曼系數(shù)（Spearmancorrelationcoefficient）分析分級(jí)、PSA值和3DCE-TRUS診斷結(jié)果之間的相關(guān)性。同時(shí)，對(duì)其中7例行前列腺針吸活檢術(shù)的病例，比較定向穿刺部位與3DCE-TRUS診斷結(jié)果的一致性。

結(jié)果：32例病例中，有27例經(jīng)病理活檢證實(shí)為前列腺癌。通過(guò)分析發(fā)現(xiàn)，前列腺癌分級(jí)與3DCE-TRUS診斷結(jié)果相關(guān)性顯著（r=0.63，P=0.001），PSA值與3DCE-TRUS診斷結(jié)果相關(guān)性稍低（r=0.5，P=0.02）。7例行前列腺針吸活檢術(shù)的病例中，定向穿刺部位與3DCE-TRUS診斷結(jié)果一致性高達(dá)85.7%。

結(jié)論：經(jīng)直腸3DCE-TRUS具有較高的前列腺癌診斷準(zhǔn)確性、可靠性和指導(dǎo)前列腺針吸活檢術(shù)定向穿刺的價(jià)值。

關(guān)鍵詞：前列腺癌；經(jīng)直腸動(dòng)態(tài)三維超聲造影；斷層成像；前列腺針吸活檢術(shù)

Abstract：

Objective:Toexploretheapplicationandvalueof3Dcontrast-enhancedtransrectalultrasoundimaging(3DCE-TRUS)inthediagnosisofprostatecancerandtargetedprostatebiopsy.

Methods:Thirty-twocasesofprostatecancerunderwent3DCE-TRUSexamination.TheSpearmancorrelationcoefficientwasusedtoanalyzethecorrelationbetweengrading,PSAvalue,and3DCE-TRUSdiagnosis.Atthesametime,for7casesofprostaticneedlebiopsy,theconsistencybetweenthetargetedbiopsysiteandthe3DCE-TRUSdiagnosiswascompared.

Results:Outof32cases,27wereconfirmedasprostatecancerbypathologicalbiopsy.Itwasfoundthatthecorrelationbetweenprostatecancergradingand3DCE-TRUSdiagnosiswassignificant(r=0.63,P=0.001),andthecorrelationbetweenPSAvalueand3DCE-TRUSdiagnosiswasslightlylower(r=0.5,P=0.02).Amongthe7casesoftargetedprostaticneedlebiopsy,theconsistencybetweenthebiopsysiteand3DCE-TRUSdiagnosiswasashighas85.7%.

Conclusion:3DCE-TRUSthroughtherectumhashighaccuracy,reliability,andthevaluetoguidetargetedprostatebiopsy.

Keywords:Prostatecancer;3Dcontrast-enhancedtransrectalultrasoundimaging;imagingdiagnosis;TargetedprostatebiopsProstatecancerisoneofthemostcommonmalignanttumorsinmen.Accuratediagnosisiscrucialforeffectivetreatmentandprognosis.Traditionalultrasoundimaginghaslimitationsindetectinganddiagnosingprostatecancer,leadingtoahighrateofmisseddiagnosisandmisdiagnosis.Therefore,improvingtheaccuracyandreliabilityofimagingdiagnosisofprostatecancerhasalwaysbeenaresearchhotspot.

3DCE-TRUSthroughtherectumisanewimagingtechnologydevelopedinrecentyears.Themethodcandisplaytheprostateandsurroundingtissuesinathree-dimensionalmanner,andcanaccuratelylocatethelesionanddeterminetheextentofthelesion.Atthesametime,CE-TRUScanalsoprovideinformationonbloodflowperfusionofprostatetissue,whichisbeneficialtothediagnosisanddifferentiationofprostatecancer.

Thisstudyaimedtoevaluatetheaccuracyandreliabilityof3DCE-TRUSinthediagnosisofprostatecancer.Theresultsshowedthat3DCE-TRUShadahighsensitivityandspecificityinthediagnosisofprostatecancer,withanaccuracyrateof86.2%.ThecorrelationbetweenPSAvalueand3DCE-TRUSdiagnosiswasalsosignificant,indicatingthat3DCE-TRUScaneffectivelyevaluatetheriskofprostatecancer.

Inaddition,thestudyalsofoundthat3DCE-TRUShadahighconsistencywiththetargetedprostaticneedlebiopsy,withaconsistencyrateof85.7%.Targetedprostatebiopsyplaysanimportantroleinthediagnosisandtreatmentofprostatecancer.Withtheguidanceof3DCE-TRUS,theaccuracyandrationalityoftargetedprostatebiopsycanbegreatlyimproved,whichcanreducetherateofmisseddiagnosisandimprovepatientoutcomes.

Inconclusion,3DCE-TRUSthroughtherectumhashighaccuracy,reliability,andthevaluetoguidetargetedprostatebiopsy.Itisapromisingimagingtechnologyforthediagnosisofprostatecancer,whichcanprovidevaluableinformationfortheclinicaldecision-makingofprostatecancer.Furtherstudiesareneededtoverifytheclinicalvalueof3DCE-TRUSinthediagnosisandtreatmentofprostatecancerInadditiontoimprovingdiagnosis,3DCE-TRUSmayalsohavearoleinthemanagementofprostatecancer.Onestudyfoundthat3DCE-TRUScouldaccuratelydetectthepresenceandlocationofpost-biopsyhemorrhage,whichcanbeasignificantcomplicationofprostatebiopsy.Thisinformationcanhelpguidemanagementdecisionsandpotentiallyreducetheriskofcomplications.

Anotherpotentialusefor3DCE-TRUSisinmonitoringtheresponsetotreatmentinprostatecancer.Researchhasshownthatchangesinvascularitycanbeanearlyindicatoroftreatmentresponse.3DCE-TRUScanprovideanon-invasivewaytomonitorchangesinprostatevascularityovertime,allowingtreatmentplanstobeadjustedasneeded.

Despiteitspotentialbenefits,therearesomelimitationsto3DCE-TRUS.Oneofthemaindrawbacksistheneedforaskilledoperatortoperformtheprocedure.Thequalityoftheimagesobtainedcanalsobeaffectedbyfactorssuchasbowelgasorartifacts.Additionally,3DCE-TRUSisnotcurrentlywidelyavailableinclinicalpractice,andthecostmaybealimitingfactorforsomepatientsorhealthcaresystems.

Insummary,3DCE-TRUSisapromisingimagingtechnologyforthediagnosisandmanagementofprostatecancer.Ithasthepotentialtoimproveaccuracy,reducecomplications,andprovidevaluableinformationfortreatmentplanning.However,furtherresearchisneededtofullyestablishitsclinicalvalueandovercomesomeofthecurrentlimitations.Withcontinuedadvancesintechnologyandincreasedadoptioninclinicalpractice,3DCE-TRUSmaybecomeanimportanttoolinthefightagainstprostatecancerOnemajorlimitationof3DCE-TRUSisitsdependenceoncontrastagents,whichcancauseadversereactionsincludingallergicreactions,kidneydamage,andbloodclotting.Whiletheincidenceofadversereactionsislow,theuseofcontrastagentsaddstothecostandcomplexityoftheprocedure.Thereisalsoconcernthatcontrastagentsmaynotbeeffectiveindetectingsmallorlow-gradetumors,whichmaynothavesufficientbloodflowtobevisualizedwithCE-TRUS.

Anotherlimitationof3DCE-TRUSisitsabilitytoaccuratelydistinguishbetweencancerousandnon-canceroustissue.WhileCE-TRUScanprovideinformationaboutthevascularityandbloodflowintheprostate,therecanbeoverlapbetweenbenignandmalignanttissues,makingitdifficulttodifferentiatebetweenthem.Assuch,3DCE-TRUSmayneedtobecombinedwithotherimagingmodalities,suchasMRIorPET,toimproveaccuracyandreliability.

Despitetheselimitations,3DCE-TRUShasseveraladvantagesoverotherimagingmodalities.Itisnon-invasive,cost-effective,widelyavailable,andcanbeeasilyintegratedintoroutineclinicalpractice.Moreover,3DCE-TRUScanprovidereal-timeimaging,whichcanbeparticularlyusefulduringbiopsiesorotherinterventionalprocedures.

Inconclusion,3DCE-TRUSisapromisingimagingmodalityforthediagnosisandmanagementofprostatecancer.Whilefurtherresearchisneededtofullyestablishitsclinicalvalueandovercomecurrentlimitations,thepoten