Application Of Magnetic Resonance Combined With Transrectal Ultrasound In Prostate Biopsy

Introduction:To explore the value of magnetic resonance combined with transrectal ultrasound in prostate biopsy.Methods:Received 110 patients(age 45-90 years old,average age 68±8.32 years old)who underwent transrectal ultrasound guided prostate biopsy and targeted biopsy from October 2016 to May 2018 in Liaoning Provincial Cancer Hospital.Age 68±8.32 years old),The period between MRI and prostate biopsy was within 1 week.Magnetic resonance imaging was performed using SIEMENS Magnetom Verio 3.0 T magnetic resonance,and a simplified prostate 12 zoning method and PI-RADS V2 score were used on MRI.Use Toshiba Aplio 780 color ultrasound instrument and frequency 7.0MHz transrectal probe,use special puncture frame and BARD inner slot cutting automatic biopsy gun,18 G biopsy needle;ultrasonically perform system puncture according to 5 zones and 13 needles.Puncture is divided into three methods:effective pre-defined zone puncture(both ultrasound and MRI can be seen)and ineffective pre-defined zone puncture(only one lesion on MRI or ultrasound image to see the lesion).Data were processed and statistical analysis was performed using IBM SPSS 20.0 statistical software.The chi-square test is used for the count data,and the t-test or rank sum test is used for the measurement data.If the normal distribution is satisfied,the mean±standard deviation(x±s)is used.If the normal distribution is not satisfied,it is expressed as the median or interquartile range.The difference was statistically significant at P <0.05.The operating characteristic curve(ROC curve)of receiver was used to evaluate the diagnostic efficacy of the two readers' scores.Kappa test was used to compare the consistency of the scores of the two readers.Results:This group of 110 cases,60 cases of prostate cancer,50 cases of benign prostate lesions;MRI images and ultrasound images were detected and puncture 122 lesions,64 lesions were prostate cancer,58 lesions were benign prostate lesions(including 45 hyperplasia,3 inflammation,3 intraepithelial neoplasia,7dysplasia).113 effective pre-defined areas(the lesion can be displayed in both ultrasound and magnetic resonance images),9 ineffective predefined areas(3 of themare displayed only on ultrasound and 6 are only displayed on MRI).There were significant differences in the echo pattern,shape,posterior echo attenuation,microcalcification and blood flow grading indications between prostate cancer and benign prostate lesions(P<0.05).The difference in T2 WI signal,shape,margin,and DWI signal on MRI was also statistically significant(P<0.05).The pathological results of biopsy were taken as the gold standard.The PI-RADS V2 scores of 119 prostate lesions on MRI were scored by two readers.The sensitivity and specificity of prostate cancer diagnosis were 85.71%,76.79%,87.30%,and 73.21%,respectively.The consistency of the two readers' diagnosis was very good(Kappa value = 0.845).A total of 60 patients with prostate cancer were detected by targeted puncture,including 275 needles and 141 positive,the detection rate of prostate cancer and the number of positive needles were 54.55% and 51.27%,respectively.A total of43 patients with prostate cancer were detected by systemic puncture,including a total of 1,430 needles and 311 positive,the detection rate of prostate cancer and the number of positive needles were 39.09% and 21.75%,respectively.The difference in the detection rate of prostate cancer combined with MRI was statistically significant(P<0.05).The difference in the number of positive needles between the two models was also statistically significant(P < 0.05).Conclusions: Benign and malignant lesions of the prostate have obvious imaging features on MRI and ultrasound images,which is helpful for the diagnosis of benign and malignant lesions.PI-RADS V2 can improve the diagnostic efficacy of benign and malignant prostate lesions.Combined with MRI and transrectal ultrasonography,the "targeted puncture + system puncture" biopsy model is used for biopsy of clinically suspected prostate lesions.It is simple,objective and efficient,and has certain clinical application value.