[直肠内核磁共振断层扫描及经直肠超声诊断在前列腺癌局部分期中的意义]
[Significance of endorectal nuclear magnetic resonance tomography and transrectal ultrasound diagnosis in local staging of prostatic carcinoma].
作者信息
May F, Treumann T, Dettmar P, Hartung R, Breul J
机构信息
Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 München.
出版信息
Urologe A. 2002 Sep;41(5):458-61. doi: 10.1007/s00120-001-0150-6.
METHODS
We assessed the staging accuracy of endorectal magnetic resonance imaging (eMRI) and transrectal ultrasonography (TRUS) for localized prostate cancer. 54 patients with biopsy proven prostate cancer underwent TRUS and eMRI prior to radical retropubic prostatectomy. The MR images were prospectively interpreted by two radiologists. These findings were compared with the histopathological results.
RESULTS
Overall accuracy of eMRI in defining local tumor stage was 93% by radiologist A and 56% by radiologist B. Overall accuracy by TRUS was 63%. Analysis of interobserver agreement showed a poor correlation regarding MRI studies. Endorectal MRI was more sensitive than TRUS for detecting capsular penetration and seminal vesicle involvement. TRUS revealed a relatively high specificity and was superior to eMRI in this regard.
CONCLUSION
This series shows the current limited value of TRUS and eMRI for planning treatment in patients with clinically localized prostate cancer.
方法
我们评估了直肠内磁共振成像（eMRI）和经直肠超声检查（TRUS）对局限性前列腺癌的分期准确性。54例经活检证实为前列腺癌的患者在耻骨后根治性前列腺切除术前行TRUS和eMRI检查。MR图像由两位放射科医生进行前瞻性解读。将这些结果与组织病理学结果进行比较。
结果
放射科医生A对eMRI确定局部肿瘤分期的总体准确率为93%，放射科医生B为56%。TRUS的总体准确率为63%。观察者间一致性分析显示，MRI研究的相关性较差。直肠内MRI在检测包膜侵犯和精囊受累方面比TRUS更敏感。TRUS显示出相对较高的特异性，在这方面优于eMRI。
结论
本系列研究表明，目前TRUS和eMRI在临床局限性前列腺癌患者治疗规划中的价值有限。
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