经直肠超声造影对前列腺良恶性结节的鉴别诊断价值
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江苏省卫生厅科研资助项目(H200847)


Value of transrectal contrast enhanced ultrasonography in the differential diagnosis of prostate nodules
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    目的:探讨超声造影(transrectal contrast-enhanced ultrasound,CEUS)对前列腺良恶性结节的鉴别诊断价值。方法:对33例前列腺疾病患者共38个结节,行经直肠超声(transrectal ultrasound,TRUS)和CEUS检查,并在超声引导下对结节进行靶向穿刺活检。术后回放CEUS检查数据,用自动追踪定量(auto tracking contrast quantification,ACQ)分析软件对感兴趣区域绘制时间强度曲线,测量定量参数,数据依据病理结果分组进行统计学分析。结果:38个结节中,良性结节有20个,前列腺癌结节18个。前列腺癌结节造影以高增强为主(14/18),而良性结节中以等增强为主(14/20)。前列腺癌结节的达峰时间(time to peak,TTP)和加速时间(accelerating time,ACT)分别为(26.03 ± 3.12) s和(8.22 ± 3.07) s,明显小于良性结节(30.98 ± 7.15) s和(12.26 ± 5.30) s,峰值强度(peak intensity,PI)为(20.43 ± 5.32) dB低于良性结节(23.51 ± 2.51)dB,差异具有统计学意义(P < 0.05)。结论:CEUS能较为客观地评价前列腺病灶及正常组织内的血流供应情况,TTP、ACT与PI等定量参数有助于前列腺良恶性结节的鉴别诊断。

    Abstract:

    Objective: To evaluate the value of transrectal contrast-enhanced ultrasound(CEUS) in the differential diagnosis of prostate begin and malignant nodules. Methods: Thirty-three patients with 38 nodes were examined with transrectal ultrasound(TRUS) and CEUS. And then nodule-target TRUS guided biopsy was performed on those nodules. After biopsy,datum of CEUS were replayed and time intensity curves(TIC) of regions of interest(ROI) were analyzed with auto tracking contrast quantification(ACQ)software. Several parameters were measured on each nodule. Statistic analyses of all data were performed between the groups divided by pathologic results. Results: Twenty of 38 nodules were benign and the other 18 ones were malignant. Most of prostate cancer nodules showed increased enhancement(14/18). However,the benign nodules mainly showed equal enhancement(14/20). The average time to peak (TTP) and accelerating time (ACT) of malignant nodule,(26.03± 3.12) s and (8.22± 3.07) s respectively,were shorter than those of benign nodule,(30.98± 7.15) s and (12.26± 5.30) s,respectively(P < 0.05). And peak intensity (PI) of prostate cancer nodule,(20.43± 5.32) dB,was lower than that of benign lesion,(23.51± 2.51) dB,P < 0.05. The difference of two groups had statistical significance. Conclusion: CEUS could reveal the presence of vasculature within the lesions of prostate cancer objectively. TTP,ACT and PI could help to discriminate prostate malignant lesions from benign ones.

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孙小林,蔡晓峰,王亚丽,汪惠宁,查月琴.经直肠超声造影对前列腺良恶性结节的鉴别诊断价值[J].南京医科大学学报(自然科学版),2011,(9):1355-1359

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  • 收稿日期:2011-03-15
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