关键词: 弹性成像, 靶向穿刺, 系统穿刺, 前列腺癌

Abstract: ［Abstract］ Objective To explore predictive value of transrectal real?time elastography （TRTE） targeted biopsy in the detection and diagnosis of prostate lesion. Methods 112 patients with suspected prostate cancer included in this study were examined with transrectal ultrasound， two needles targeted biopsy for suspicious lesions and traditional 12?needles systemic biopsy were performed under TRTE guidance. Moreover， we evaluated the diagnostic value of TRTE for prostate disease and compared accuracy of targeted biopsy and systemic biopsy. Results In this study， 54 cases of prostate cancer and 58 cases of benign prostatelesions were diagnosed with TRTE. 70 cases were diagnosed as benign prostate lesions and 42 were diagnosed as prostate cancer according to pathological examination. The sensitivity， specificity， accuracy， positive predictive value and negative predictive value were 88.1%， 75.7%， 80.3%， 0.68， 0.91， respectively. TRTE guided targeted biopsy to diagnose prostate cancer with 84 needles， the positive rate was 37.5% （84/224）， and the systematic biopsy for prostate cancer diagnosis with 313 needles， the positive rate was 23.3% （313/1344）， showing a statistically significant difference （χ2=4.08， P<0.05）. Additionally， the number of needle used for the diagnosis of prostate cancer by targeted and systematic biopsy was 397， and the positive rate was 25.3% （397/1568）. Conclusion TRTE has higher sensitivity， specificity and accuracy in the diagnosis of prostate lesions， and TRTE guided targeted biopsy has higher accuracy than systematic biopsy in diagnosing prostate cancer. However， targeted biopsy have not completely replaced systematic biopsy， and combination of them is currently the main way to reduce the false negative rate of prostate cancer.

Key words: transrectal real?time elastography, systemic biopsy prostate cancer, targeted biopsy