Abstract：Objective: To explore the clinical application value of magnetic resonance imaging （MRI） cognitive fusion for prostate puncture to improve the positive rate of early prostate cancer biopsy puncture. Methods: The clinical data of patients with suspected prostate cancer admitted to the Department of Urology, the Second Affiliated Hospital of Nantong University from July 2017 to December 2018 were collected retrospectively. All patients underwent transrectal sonography-guided prostate biopsy in our hospital, and were divided into two groups according to whether MRI examination was performed before the biopsy. Pathological examination results were used as the gold standard to compare the different results of needle biopsy for prostate cancer between the two groups. Results: Totally 183 patients successfully completed prostate biopsy, and 91 patients were pathologically diagnosed with prostate cancer, with a positive detection rate of 49.7% （91/183） and Gleason score ≥7 in 37 cases. There were 28 cases of prostatic intraepithelial neoplasia （15.3%） and 53 cases of benign hyperplasia （28.96%）. The positive rate of transrectal ultrasound （TRUS）-guided conventional 12-needle prostatectomy was 41%. The positive rate of TRUS-MRI cognitive fusion guided standard and combined targeted puncture was 56%. The positive rate of TRUS-MRI cognitive fusion guided conventional system combined with targeted puncture was higher than that of TRUS-guided conventional system （χ2 = 4.117, P = 0.042）. Among the 183 patients, the positive rate of puncture positive needles was 49.73%, significantly higher than the digital rectal examination （DRE） positive rate （39.34%） （χ2 = 3.993, P = 0.046）. In addition, the detection rate of prostate cancer under TRUS-MRI cognitive fusion was significantly higher than that under conventional TRUS guided puncture （χ2 = 4.32, P = 0.038）. There were no statistically significant differences in age, prostate specific antigen, PV, body mass index, DRE and Gleason scores between the two groups （P > 0.05）. All patients were followed up for 72 h after operation without acute serious complications and recovered well. Conclusion: Guided prostate biopsy under ultrasonic magnetic resonance cognitive fusion can help improve the positive detection rate of early prostate cancer, and can make better individualized and accurate diagnosis plans for patients.
