| 摘要: |
| 目的 探讨容积导航经直肠超声（TRUS）与多参数磁共振成像（MP-MRI）实时融合状态下TRUS图像可疑区域与前列腺病灶的风险相关性。
方法 回顾性分析114例经容积导航TRUS与MP-MRI影像融合引导靶向穿刺病理证实前列腺癌患者，根据TRUS图像是否存在可疑区域分为超声可见组和超声未见组，比较两组PI-RADS评分及病理Gleason评分的关系。
结果 114例患者中，阳性组70例，阴性组44例。共114个病灶，PI-RADS 5分占41.23%，4分占37.72%，PIRADS 3占15.79%，PIRADS 2占5.26%。在PI-RADS 3分及以下病灶中，有25%（6/24）超声表现为阳性；PI-RADS 4分和5分病灶中，有71.1%（64/90）超声表现为阳性；PI-RADS 5分病灶中，有 89%（42/47） 超声表现为阳性，二者分布比较差异有统计学意义（P＜0.01）。阳性组中77.1%（54/70）前列腺癌穿刺标本病理Gleason评分在7（4+3）分及以上；而阴性组中36.3%（16/44）前列腺癌穿刺标本病理Gleason评分在7（4+3）及以上，二者比较差异有统计学意义（P＜0.01）。
结论 在PIRADS评分4分及5分的前列腺病灶中，TRUS图像更容易存在可疑区域；TRUS图像存在可疑区域的病灶中大部分病理评分多为高危性前列腺癌，提示存在更大的高危前列腺癌风险。 |
| 关键词: 前列腺癌 经直肠超声 多参数磁共振成像 前列腺成像报告和数据系统 影像融合 |
| DOI： |
| 投稿时间：2022-03-09修订日期：2022-09-08 |
| 基金项目:深圳市人民医院临床研究培育项目（SYLCYJ202008） |
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| Correlation between the suspicious areas in TRUS images based on TRUS/MP-MRI image fusion and the risk of prostate lesions |
| WEI zhanghong,YE xiuqing,DING zhimin,Xu |
| () |
| Abstract: |
| Objective The aim of this study was to investigate the risk correlation between suspicious areas of TRUS images and prostate lesions under the real-time fusion of volume-navigated transrectal ultrasound （TRUS） and multiparametric magnetic resonance imaging （MP-MRI）.Methods A retrospective analysis of 114 patients with pathologically confirmed prostate cancer by volume-navigated TRUS/MP-MRI image fusion guided targeted biopsy was performed，and the relationship between the presence of suspicious areas in TRUS images and MP-MRI PIRADS score and pathological Gleason score was analyzed.Results Among 114 patients, 70 were in the positive group and 44 were in the negative group. There were 114 lesions in total, PI-RADS score 5 accounted for 41.23%, score 4 accounted for 37.72%, PIRADS 3 accounted for 15.79%, and PIRADS 2 accounted for 5.26%. Of the PI-RADS 3 and lower lesions, 25% (6/24) were positive on ultrasound; 71.1% (64/90) of the PI-RADS 4 and 5 lesions were positive on ultrasound; and 89% (42/47) of the PI-RADS 5 lesions were positive on ultrasound, with a statistically significant difference between the two distributions (P < 0.01). In the positive group, 77.1% (54/70) of the prostate cancer puncture specimens had a pathological Gleason score of 7 (4+3) or higher, while 36.3% (16/44) of the negative group had a pathological Gleason score of 7 (4+3) or higher, with a statistically significant difference (P < 0.01).
Conclusion Among the prostate lesions with PIRADS score of 4 and 5，suspicious areas were more likely to be found in TRUS images；most of the lesions with suspicious areas in TRUS images were mostly high-risk prostate cancer，suggesting a greater risk of high-risk prostate cancer. |
| Key words: prostate cancer, transrectal ultrasonography, multi-parameter magnetic resonance imaging, prostate imaging report and data system, imaging fusion |
