阅读说明：本技术 磁共振靶向前列腺穿刺在前列腺癌诊断中的应用 (Application of magnetic resonance targeted prostate puncture in prostate cancer diagnosis ) 是由 侯俊清 徐卫波 李松 王斌杰 赵振华 后森林 张建华 于 2020-12-31 设计创作，主要内容包括：本发明公开了一种磁共振靶向前列腺穿刺在前列腺癌诊断中的应用,包括首先标记前列腺高分辨率多个切面的MRI、T2W TSE序列图像上标记穿刺靶点,然后将MRI的矢状面重建图像与经直肠超声的矢状面图像显示于同一屏幕上,使其融合同步显示,在13针穿刺基础上对靶点加穿3针。本发明涉及生物学诊断应用技术领域,具体是提供了一种磁共振与经直肠前列腺彩超影像融合技术可以精确指导穿刺枪对目标靶点行“靶向穿刺”,从而提高前列腺癌早期诊断率的磁共振靶向前列腺穿刺在前列腺癌诊断中的应用。(The invention discloses an application of magnetic resonance targeted prostate puncture in prostate cancer diagnosis, which comprises the steps of marking puncture target points on MRI and T2W TSE sequence images of a plurality of high-resolution sections of prostate, displaying a sagittal plane reconstructed image of the MRI and a sagittal plane image of transrectal ultrasound on the same screen, enabling the sagittal plane reconstructed image and the sagittal plane image to be fused and displayed synchronously, and penetrating 3 needles on the target points on the basis of 13-needle puncture. The invention relates to the technical field of biological diagnosis application, and particularly provides application of magnetic resonance targeted prostate puncture in prostate cancer diagnosis, wherein the magnetic resonance targeted prostate puncture can accurately guide a puncture gun to perform targeted puncture on a target point by using a transrectal prostate color ultrasound image fusion technology, so that the early diagnosis rate of prostate cancer is improved.)

1. The application of magnetic resonance targeted prostate puncture in prostate cancer diagnosis is characterized in that: the method comprises the following steps:

s1: patient selection, inclusion criteria for prostate patients: a. the total prostate specific antigen value is 4.00-100.00 ng/ml; b. a DRE touch exception; c. abnormal images are found in prostate ultrasound and magnetic resonance examination; 100 patients are collected;

exclusion criteria: A. prostate cancer potential without any other adjuvant examination; B. TPSA is more than 100.00ng/ml, bone metastasis is found, and the puncture biopsy is only a pathological diagnostician; C. rejecting the prostate MRI examination or the prostate MRI does not have abnormal signals; D. the prior history of prostate aspiration biopsy operation;

s2: MRI imaging examination: a patient performs MRI imaging examination by using an MRI (magnetic resonance imaging) prostate flat scan and enhancement 3.0T MRI scanner, and acquires signals by using a 32-channel phase control surface coil and a dual-source parallel radio frequency pulse excitation transmission technology; the main scanning sequence: an axial position/coronal position/sagittal position T2WI fast spin echo sequence, wherein all MRI prostate flat scanning and enhanced images are analyzed by reading of a two-position senior medical radiologist, and prostate targets with a PI-RADS score of 3-5 are labeled;

s3: patient diagnosis procedure: i, taking a lithotomy position by a patient, advising the patient to pull the scrotum upwards and fully expose the perineum; II, disinfecting with iodophor with the concentration of 0.5-1%, and paving a sterile towel; III, placing a rectal ultrasonic probe of an ultrasonic diagnostic apparatus from the anus, wherein the rectal ultrasonic probe is sleeved with a sterile rubber sleeve, and locally anaesthetizing a puncture part by using 1% lidocaine until reaching the prostate capsule; introducing reconstructed magnetic resonance image data saved by adopting a standard DICOM format into an RVS imaging fusion system, marking a puncture target point on an MRI/T2WTSE sequence image of a plurality of high-resolution sections pre-loaded into a puncture biopsy system, placing a magnetic field generator beside a patient, connecting a magnetic field position sensor for capturing a transrectal ultrasound image with a transrectal ultrasound probe, displaying a sagittal plane reconstructed image of the MRI and a sagittal plane image of the transrectal ultrasound on the same screen, and calibrating 2 images by taking an intra-urethral orifice as a common reference so as to synchronously display the fusion; v, corresponding the upper target point of magnetic resonance to the corresponding position of the transrectal ultrasound image, and performing transperineal prostate puncture by 3 needles aiming at each target point by a free arm method; VI, fixing the specimen obtained by the puncture biopsy needle with 10% formalin solution, marking and then sending the specimen to pathological examination.

2. Use of magnetic resonance targeted prostate puncture in prostate cancer diagnosis according to claim 1, characterized in that: in step S1, if any of the conditions a, b, and c meets the above condition, the selection can be performed.

3. Use of magnetic resonance targeted prostate puncture in prostate cancer diagnosis according to claim 1, characterized in that: the DRE access abnormality in step S1 includes the presence of a hard or nodular prostate.

4. Use of magnetic resonance targeted prostate puncture in prostate cancer diagnosis according to claim 1, characterized in that: the biopsy needle in step S3 is an 18G fully automatic biopsy gun.

Technical Field

The invention relates to the technical field of biological diagnosis application, in particular to application of magnetic resonance targeted prostate puncture in prostate cancer diagnosis.

Background

Medically, cancer (cancer) refers to a malignant tumor that originates in epithelial tissue, and is the most common type of malignant tumor. Correspondingly, malignant tumors originating in mesenchymal tissue are collectively referred to as sarcomas. There are a few malignant tumors that are not named according to the above principles, such as wilms' tumor, malignant teratoma, etc. The general term "cancer" is used to generally refer to all malignant tumors. Cancer has biological characteristics such as abnormal cell differentiation and proliferation, loss of control of growth, infiltrability, and metastasizing.

The prostate cancer is a malignant tumor with extremely high urinary system incidence, is caused by malignant tumor lesion at the epithelium of the prostate, and the incidence of the prostate cancer in the prostate male is gradually increased after the age of 55, and the incidence of the prostate cancer is increased along with the increase of the age.

Currently, the clinical diagnosis of prostate cancer mainly depends on digital rectal examination, serum PSA, transrectal ultrasound of prostate and pelvic MRI examination, and the sensitivity of CT to early diagnosis of prostate cancer is lower than that of MRI. Because of the high bone metastasis rate of prostate cancer, a nuclide bone scan examination is usually performed before a treatment plan is determined, and pathological examination through a prostate needle biopsy is required for diagnosing prostate cancer. However, the general prostate puncture biopsy usually takes the median perineum as a boundary, the distance between the left side and the right side and the midline is 1.5cm, and the distance above the anus is 2cm as a puncture point, so that the accuracy of puncture is not high, and the diagnosis of prostate cancer is influenced.

In the MRI, T2WI, diffusion weighted imaging and dynamic enhancement (DCE) are used as core sequences, the information such as the infiltration range of PCa and whether distant metastasis exists is provided, and the method has great value for early diagnosis and clinical staging of PCa. More tissues of the peripheral zone and the tip of the prostate can be obtained through perineal prostate puncture, and the puncture positive rate is improved.

Disclosure of Invention

In order to solve the existing problems, the invention provides the application of magnetic resonance targeted prostate puncture in prostate cancer diagnosis, which can accurately guide a puncture gun to perform targeted puncture on a target point by using a magnetic resonance and transrectal prostate color ultrasound image fusion technology, so that the early diagnosis rate of prostate cancer is improved.

The technical scheme adopted by the invention is as follows: the invention relates to an application of magnetic resonance targeted prostate puncture in prostate cancer diagnosis, which comprises the following steps:

s1: patient selection, inclusion criteria for prostate patients: a. the total prostate specific antigen value is 4.00-100.00 ng/ml; b. a DRE touch exception; c. abnormal images are found in prostate ultrasound and magnetic resonance examination; 100 patients are collected;

exclusion criteria: A. prostate cancer potential without any other adjuvant examination; B. TPSA is more than 100.00ng/ml, bone metastasis is found, and the puncture biopsy is only a pathological diagnostician; C. rejecting the prostate MRI examination or the prostate MRI does not have abnormal signals; D. the prior history of prostate aspiration biopsy operation;

s2: MRI imaging examination: a patient performs MRI imaging examination by using an MRI prostate flat scan plus enhancement and a 3.0TMRI scanner, and acquires signals by using a 32-channel phase control surface coil and a dual-source parallel radio frequency pulse excitation transmission technology; the main scanning sequence: an axial position/coronal position/sagittal position T2WI fast spin echo sequence, wherein all MRI prostate flat scanning and enhanced images are analyzed by reading of a two-position senior medical radiologist, and prostate targets with a PI-RADS score of 3-5 are labeled;

s3: patient diagnosis procedure: i, taking a lithotomy position by a patient, advising the patient to pull the scrotum upwards and fully expose the perineum; II, disinfecting with iodophor with the concentration of 0.5-1%, and paving a sterile towel; III, placing a rectal ultrasonic probe of an ultrasonic diagnostic apparatus from the anus, wherein the rectal ultrasonic probe is sleeved with a sterile rubber sleeve, and locally anaesthetizing a puncture part by using 1% lidocaine until reaching the prostate capsule; introducing reconstructed magnetic resonance image data saved by adopting a standard DICOM format into an RVS imaging fusion system, marking a puncture target point on an MRI/T2W TSE sequence image of a plurality of high-resolution sections pre-loaded into a puncture biopsy system, placing a magnetic field generator beside a patient, connecting a magnetic field position sensor for capturing a transrectal ultrasound image with a transrectal ultrasound probe, displaying a sagittal plane reconstructed image of the MRI and a sagittal plane image of the transrectal ultrasound on the same screen, and calibrating 2 images by taking an intraurethral orifice as a common reference so as to fuse and display the images synchronously; v, corresponding the upper target point of magnetic resonance to the corresponding position of the transrectal ultrasound image, and performing transperineal prostate puncture by 3 needles aiming at each target point by a free arm method; VI, fixing the specimen obtained by the puncture biopsy needle with 10% formalin solution, marking and then sending the specimen to pathological examination.

Further, any one of the conditions a, b, and c in step S1 may be selected.

Further, the DRE access abnormality in step S1 includes the presence of hardness or nodules in the prostate region

Further, the biopsy needle used in the step S3 is an 18G fully automatic biopsy gun.

The beneficial effects obtained by adopting the scheme are as follows: the application of the magnetic resonance targeted prostate puncture in prostate cancer diagnosis in the scheme explores the magnetic resonance targeted prostate puncture value and improves the diagnosis rate of early prostate cancer, firstly marks puncture target points on MRI and T2W TSE sequence images of a plurality of high-resolution sections of prostate, then displays the sagittal plane reconstructed image of MRI and the sagittal plane image of transrectal ultrasound on the same screen, enables the images to be fused and displayed synchronously, and 3 needles are inserted into the target points on the basis of 13-needle puncture. The magnetic resonance and transrectal prostate color ultrasound image fusion technology can accurately guide a puncture gun to carry out targeted puncture on a target point, thereby improving the early diagnosis rate of the prostate cancer.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all embodiments; all other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

The invention discloses an application of magnetic resonance targeted prostate puncture in prostate cancer diagnosis, which comprises the following steps:

s1: patient selection, inclusion criteria for prostate patients: a. the total prostate specific antigen value is 4.00-100.00 ng/ml; b. a DRE touch exception; c. abnormal images are found in prostate ultrasound and magnetic resonance examination; 100 patients are collected;

exclusion criteria: A. prostate cancer potential without any other adjuvant examination; B. TPSA is more than 100.00ng/ml, bone metastasis is found, and the puncture biopsy is only a pathological diagnostician; C. rejecting the prostate MRI examination or the prostate MRI does not have abnormal signals; D. the prior history of prostate aspiration biopsy operation;

s2: MRI imaging examination: a patient performs MRI imaging examination by using an MRI (magnetic resonance imaging) prostate flat scan and enhancement 3.0T MRI scanner, and acquires signals by using a 32-channel phase control surface coil and a dual-source parallel radio frequency pulse excitation transmission technology; the main scanning sequence: an axial position/coronal position/sagittal position T2WI fast spin echo sequence, wherein all MRI prostate flat scanning and enhanced images are analyzed by reading of a two-position senior medical radiologist, and prostate targets with a PI-RADS score of 3-5 are labeled;

s3: patient diagnosis procedure: i, taking a lithotomy position by a patient, advising the patient to pull the scrotum upwards and fully expose the perineum; II, disinfecting with iodophor with the concentration of 0.5-1%, and paving a sterile towel; III, placing a rectal ultrasonic probe of an ultrasonic diagnostic apparatus from the anus, wherein the rectal ultrasonic probe is sleeved with a sterile rubber sleeve, and locally anaesthetizing a puncture part by using 1% lidocaine until reaching the prostate capsule; introducing reconstructed magnetic resonance image data saved by adopting a standard DICOM format into an RVS imaging fusion system, marking a puncture target point on an MRI/T2W TSE sequence image of a plurality of high-resolution sections pre-loaded into a puncture biopsy system, placing a magnetic field generator beside a patient, connecting a magnetic field position sensor for capturing a transrectal ultrasound image with a transrectal ultrasound probe, displaying a sagittal plane reconstructed image of the MRI and a sagittal plane image of the transrectal ultrasound on the same screen, and calibrating 2 images by taking an intraurethral orifice as a common reference so as to fuse and display the images synchronously; v, corresponding the upper target point of magnetic resonance to the corresponding position of the transrectal ultrasound image, and performing transperineal prostate puncture by 3 needles aiming at each target point by a free arm method; VI, fixing the specimen obtained by the puncture biopsy needle with 10% formalin solution, marking and then sending the specimen to pathological examination.

In step S1, if any of the conditions a, b, and c meets the above condition, the selection can be performed.

The DRE access abnormality in step S1 includes the presence of hardness or nodules in the prostate region

The biopsy needle in step S3 is an 18G fully automatic biopsy gun.

The scheme explores the value of magnetic resonance targeted prostate puncture and improves the diagnosis rate of early prostate cancer, firstly marks puncture target points on MRI and T2W TSE sequence images of a plurality of high-resolution sections of the prostate, then displays the sagittal plane reconstructed image of the MRI and the sagittal plane image of transrectal ultrasound on the same screen, so that the images are fused and synchronously displayed, and 3 needles are inserted into the target points on the basis of 13-needle puncture. The magnetic resonance and transrectal prostate color ultrasound image fusion technology can accurately guide a puncture gun to carry out targeted puncture on a target point, thereby improving the early diagnosis rate of the prostate cancer.

The invention and its embodiments have been described above without limitation, and the actual junction scheme is not limited thereto. In summary, those skilled in the art should appreciate that they can readily use the disclosed conception and specific embodiments as a basis for designing or modifying other structures for carrying out the same purposes of the present invention without departing from the spirit and scope of the invention as defined by the appended claims.