黄秀荫,李云杉,陈浩易,银航菲,张步林

前列腺癌（PCa）是男性泌尿系统最常见的恶性肿瘤之一，近年来发病率和死亡率持续上升。传统经直肠超声引导下的系统性活检虽然操作成熟，但存在漏诊前列腺前部及尖部病灶、病理分级低估及感染并发症较高等局限。近年来，随着多模态影像技术的发展，基于经直肠超声的多模态影像引导经会阴前列腺靶向穿刺活检逐渐成为精准诊断PCa尤其是临床显著前列腺癌（csPCa）的重要手段。该方法综合利用灰阶超声、弹性成像、微超声、超声造影、多参数磁共振成像与人工智能辅助分析，实现病灶的精准定位与实时导航，有效提高靶向命中率、降低感染风险，并优化病理风险分层。本文综述了多模态经直肠超声引导经会阴前列腺靶向穿刺的技术基础、临床应用价值、存在问题及发展趋势，旨在为PCa的精准诊断和个体化治疗提供参考。

前列腺癌；经直肠超声；多模态超声；靶向活检；人工智能

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