Application Study Of Transrectal Prostate Targeted Needle Biopsy Guided By The Cognitive Fusion Of Multiparametric MRI And Transrectal Ultrasound

Objective:To analyze and compare multi-parameter magnetic resonance and transrectal ultrasound(MRI-TRUS)guided transrectal prostate targeted puncture combined with systemic puncture biopsy(TB+SB)and rectal ultrasound guided systemic puncture biopsy(SB)The detection rate,safety,and incidence of postoperative complications of the two puncture methods.Provide relevant guidance for prostate puncture in clinical work.Methods:Collected and analyzed 370 cases of TRUS biopsy performed in the departments of this hospital from January 2019 to January 2021.After excluding the cases that did not meet the inclusion criteria,the study has 307 cases.The collected patient data included Patient age,DRE,t PSA,PSAD,prostate volume,MRI results,number of puncture needles,puncture method,biopsy pathological results,postoperative complications,etc.Divide the patients into two groups,one group underwent TB+SB guided by MRI-TRUS cognitive fusion,and the other group underwent SB guided by TRUS.The pathological results of the two groups were analyzed and statistics were compared,and the positive puncture of the two groups were compared.Rate and postoperative complication rate.SPSS 24.0 statistical software package was used to process the data.Results:1.The age,digital rectal examination and t PSA level of the two groups of patients were not statistically significant between the two groups.The average number of puncture needles in group A was less than that in group B,which was statistically significant(P<0.001);2.The positive rate of puncture when PSA<=4ng/ml was 15.38%;the positive rate of puncture when 4<PSA<=10ng/ml was positive The rate was 24.56%;the positive rate of puncture was 32.00% when10<PSA<=20ng/ml;the positive rate of puncture when 20<PSA<=50ng/ml was53.84%;the positive rate of puncture when PSA>50ng/ml 82.47%;3.Patients with4<PSA<=10 interval,when PSAD >=0.15,the positive rate of puncture is 25.0%,when PSAD<0.15,the positive rate of puncture is 24.0%,and the positive rate of puncture when PSAD is positive is higher in this interval When PSAD is negative,the difference between the two is not statistically significant(P=1.0).For patients in the interval of 10<PSA<=20,the positive rate of puncture is 35.4% when PSAD>=0.15,and the positive rate of puncture is 10.0 when PSAD<0.15 %,the positive rate of puncture when PSAD is positive is higher than when PSAD is negative in this interval,the difference between the two is not statistically significant(P>0.05);for patients in the interval of 20<PSA<=50,when PSAD>=0.15,puncture is positive The rate was 46.3%,the positive rate of puncture when PSAD was less than 0.15 was 90.9%,the positive rate of puncture when PSAD was positive was lower than when PSAD was negative in this interval,the difference was statistically significant(P<0.05);4.Group A patients,The total puncture positive rate was 56.3%,the total puncture positive rate of patients in group B was 43.6%,which was statistically significant(P<0.05);5.There were 97 patients with DRE positive in the two groups,and 68 patients with puncture were positive.The positive rate was 70.1%.There were 210 DRE-negative patients,87 of which were positive for puncture,and the positive rate for puncture was 41.43%.The positive rate of puncture in the positive group of rectal examination was higher than that of the negative group of rectal examination,the difference was statistically significant(P<0.001);6.84 cases of clinically significant cancer were found in group A,and the positive rate of puncture was 50.9%;B The group found 54 cases of clinically significant cancer,the positive rate of puncture was 38.0%,the difference between the two groups was statistically significant(P<0.05);7.The two groups of patients underwent targeted puncture with 550 needles,the number of positive needles was 262,and the positive rate was 47.6%.;The number of puncture needles in the system was 3184,of which the number of positive needles was 1034,and the positive rate was 32.5%.The difference between the two groups was statistically significant(P<0.001);8.There was no significant difference in the complication rate of the puncture method between the two groups,including blood in the stool,hematuria,and fever.Conclusion:Transrectal prostate targeted puncture combined with system puncture biopsy(TB+SB)guided by cognitive fusion of multi-parameter magnetic resonance and transrectal ultrasound(MRI-TRUS)has a better detection rate.And there was no difference in complications between the two groups.