经直肠超声造影定量分析对前列腺良恶性疾病的诊断价值

目的 探讨经直肠超声造影对前列腺良恶性疾病鉴别诊断的价值. 方法对78例前列腺病变患者行经直肠前列腺超声造影检查,应用时间-强度曲线（TIC）测得感兴趣区（ROI）各灌注参数,即始增时间（AT）、达峰时间（TTP）、上升支斜率（β）及强度减半时间（T1/2）;并对活检组织行免疫组织化学分析,并分析前列腺组织微血管密度（MVD）与病理类型的关系.结果 78例前列腺病变患者经病理检查诊断为良性病变52例,其中良性前列腺增生34例,前列腺上皮内瘤18例;恶性病变26例,均为前列腺癌.21例前列腺癌病灶的TIC曲线形态呈速升速降型,39例良性病变呈速升缓降或经过一个平台期后速升缓降型.前列腺癌病灶的灌注参数β平均为0.23±0.10大于良性病变0.14±0.05 （P＜0.01）,T1/2为（19.13±5.98）s小于良性病变（28.22±6.29）s,P＜0.01.前列腺癌病灶的的MVD值平均为40.5±11.3大于良性病变30.0±9.8（P〈0.05）,且前列腺癌病灶的灌注参数β及T1/2与MVD呈显著正相关（r=0.51、r=0.57,P均〈0.05）.结论 经直肠超声造影灌注TIC曲线定量分析可用来评估前列腺恶性病变的微血管生成情况,对前列腺良恶性病变的鉴别诊断具有一定价值.

Evaluation of contrast-enhanced transrectal ultrasound in diagnosis of prostatic disease

Objective To study the evaluation of contrast-enhanced transrectal ultrasound （CETRUS） in diagnosis of prostatic disease. Methods A total of 78 patients with prostatic disease had contrast-enhanced transrectal ultrasound examination. The real-time observation of dynamic perfusion and analysed time-intensity curve （TIC） in the region of interest （ROI） were performed. The accentuation time （AT） , time to peak（TTP） , the slope rate of ascending curve（13） ,time of half bubble wash out （Tt/2 ） and the micro-vessel density （MVD） were analysed respectively in the patients with prostatic tissue. Results Seventy-eight patients were classified into three groups according to pathological results. The TIC characteristic in majority of prostatic cancer patients（75.00% ,39/52）and patients with benign prostatic disease （ 13/16, 81.25% ） rose and descended rapidly and slowly in majority of BPH （21/29, 82.75% ）. In the region of interest （ROI） , the TIC had difference among the two groups of the prostatic disease. The slope rate of ascending curve （13） and Tt/2 among the groups were statistically significance （P 〈 0.05 ）. The MVD was higher in patients with prostatic cancer than that in the patients with benign prostatic disease. The [3 and Tt/2 showed significant correlation with MVD in patients with prostatic cancer （r =0. 51, P 〈0.01 ）. Conclusion The CETRUS with the TIC has the preliminary clinical significance in diagnosis on prostatic disease, which is valuable for evaluation of the micro-vessel angiogenesis in prostate.