摘要
目的基于MRI多参数评价激光剜除治疗中重度良性前列腺增生(BPH)的临床疗效。方法选取中重度BPH患者144例,均接受超声引导下经尿道激光剜除术,于术前、术后1个月和6个月采用1.5T对比增强MRI序列(包括T1WI、T2WI和DWI)评价前列腺体积、激光剜除面积、针迹可视化、尿道周围水肿、腔隙和尿道形态保存,比较血清前列腺特异性抗原(PSA)、尿动力学最大尿流率(Qmax)和排泄后残留尿量(PVR)、国际前列腺症状评分(IPSS)和国际生活质量(I-QoL)评分,使用Clavien Dindo量表评估不良事件。结果手术前后患者血清PSA水平无明显变化(F=0.56,P>0.05)。术后1个月和6个月患者Qmax和I-QoL评分较术前明显升高,PVR和IPSS评分较术前明显下降(LSD-t分别=5.63、3.65;33.32、19.65;22.30、11.21;42.32、89.63,P均<0.05)。术后1个月和6个月MRI显示前列腺体积比术前明显缩小,术后6个月剜除面积比术后1个月明显缩小,针迹可视化率、水肿率和腔隙率明显下降(t=102.32,χ^(2)分别=148.56、184.11、120.60,P均<0.05),尿道形态保存率与术前相比无明显变化(χ^(2)=0.68,P>0.05)。随访6个月无严重不良事件发生。结论对比增强MRI多个序列能够定量和定性评价激光剜除治疗中重度BPH的临床疗效,有较好的应用价值。
Objective To evaluate the clinical efficacy of laser enucleation for moderate to severe benign prostatic hyperplasia(BPH)based on MRI multi-parameters.Methods Totally 144 patients with moderate to severe BPH were enrolled.Transurethral laser enucleation under the guidance of ultrasound was performed.Before operation,1 month and 6 months after operation,1.5T contrast-enhanced MRI sequences(including T1WI,T2WI and DWI)was used to evaluate prostate volume,laser ablation area,needle track visualization,periurethral edema,cavity and urethral shape preservation,serum prostate specific antigen(PSA),urodynamics[Qmax and postvoid residual(PVR)].The IPSS and international quality of life(I-QoL)scores were compared,and Clavien-Dindo scale was used to evaluate adverse events.Results There was no differences of serum PSA level before and after operation(F=0.56,P>0.05).Qmax and I-QoL score at 1 month and 6 months after operation increased significantly,PVR and IPSS score decreased significantly when compared to that before operation(LSD-t=5.63,3.65,33.32,19.65,22.30,11.21,42.32,89.63,P<0.05).MRI at 1 month and 6 months after operation showed that prostate volume was significantly smaller than that before operation,ablation area at 6 months after operation was significantly smaller than that at 1 month after operation,what’s more,the rates of needle track visualization,edema and cavity were significantly less(t=102.32,χ^(2)=148.56,184.11,120.60,P<0.05),but the rate of urethral shape preservation did not change compared with that before operation(χ^(2)=0.68,P>0.05).There was no serious adverse event in the follow-up of 6 months.Conclusion Multiple sequences of contrast-enhanced MRI can quantitatively and qualitatively evaluate the clinical efficacy of laser enucleation in the treatment of moderate to severe BPH,which has good application value.
作者
陈君
何桂兵
方萍
CHEN Jun;HE Guibing;FANG Ping(Department of Radiology,Jinhua People's Hospital,Jin-hua 321000,China)
出处
《全科医学临床与教育》
2023年第7期588-592,共5页
Clinical Education of General Practice
基金
金华市科技计划项目(2021-4-069)。
关键词
对比增强MRI
激光剜除
良性前列腺增生
国际前列腺症状评分
尿动力学
contrast enhanced MRI
laser enucleation
benign prostatic hyperplasia
international prostate symptom score
urodynamics
