摘要
目的探讨多参数磁共振联合术中实时超声导航精囊镜手术对血精症的诊治价值.方法选取合肥市第二人民医院泌尿外科2009年9月-2022年12月诊断为血精症并接受经尿道精囊镜手术治疗的患者共179例,接受多参数磁共振联合术中实时超声导航精囊镜手术的46例患者纳入实验组,接受传统影像学检查指导手术的133例患者则纳入对照组.采用倾向得分匹配方法均衡基线,匹配的协变量包括年龄、体重指数(BMI)和病程.两组各匹配到38例患者,比较两组进镜成功率、手术时间的差异.以术中所见为标准,计算多参数磁共振诊断结果的灵敏度、特异度、准确度、阳性预测值、阴性预测值,比较磁共振报告和术中所见Kappa一致性系数.结果匹配后两组间基线数据在统计学上没有显著差异(P>0.05);在手术的成功率和持续时长方面却存在显著差异(P<0.05);多参数磁共振对血精症的病因诊断准确性高,报告与术中所见高度一致.结论多参数磁共振联合术中超声导航精囊镜手术可以显著提高术前病因诊断率和手术成功率,效果优于传统手术.
Objective In this study,we will Investigate the diagnostic and therapeutic significance of employing multi-parameter magnetic resonance imaging with real-time ultrasound-guided transurethral seminal vesiculoscopy surgery in the treatment of hematospermia.Methods From September 2009 to December 2022,we collected data on 179 patients diagnosed with hemospermia treated with transurethral seminal vesiculoscopy surgery at the Second People’s Hospital of Hefei.Experimental group(46 cases)underwent multi-parameter magnetic resonance imaging along with real-time ultrasound-guided seminal vesiculoscopy surgery,while the control group(133 cases)received surgery guided by traditional imaging techniques.A propensity score matching method was used to balance baseline characteristics,such as age,BMI,and disease duration.Each group consisted of 38 patients,and differences in success rates,surgical times were compared.Using intraoperative findings as the criterion,we compare preoperative MRI examinations with intraoperative observations,calculate the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MRI diagnostic results,and compare the Kappa consistency coefficient between MRI and intraoperative findings.Results In matching,no significant differences between the two groups were found(P>0.05).Surgical success rate and surgical duration,however,differed significantly(P<0.05).The positive diagnostic rate of multi-parameter MRI is relatively high,and the results are highly consistent with intraoperative observations,playing a crucial role in preoperative examinations for hematospermia.Conclusion The utilization of multi-parameter magnetic resonance combined with real-time ultrasound-guided transurethral seminal vesiculoscopy surgery significantly enhances preoperative diagnostic accuracy and surgical success rates,these outcomes strongly indicate the superior efficacy of this approach over traditional methods.
作者
王朗
张艳斌
Wang Lang;Zhang Yanbin(Department of Urology,The Second People’s Hospital of Hefei,Hefei Hospital Affiliated to Anhui Medical University,Hefei,Anhui 230011,China;The Fifth Clinical School of Medicine,Anhui Medical University,Hefei,Anhui 230032,China)
出处
《首都食品与医药》
2024年第15期95-98,共4页
Capital Food Medicine
基金
安徽省重点研究与开发计划项目(NO:S2022e07020100)。
关键词
精囊镜
血精
经直肠实时超声
多参数磁共振
seminal vesiculoscopy
hematospermia
real-time transrectal ultrasonography
multi-parameter magnetic resonance
