经直肠前列腺超声造影在鉴别诊断前列腺癌与前列腺增生中的价值

目的 评价经直肠前列腺超声造影增强表现鉴别诊断前列腺癌与前列腺增生的临床应用价值.方法 对86例经直肠前列腺超声发现前列腺结节病变患者先后进行超声造影及经直肠前列腺穿刺活检.造影图像由两名医师分别进行独立分析并记录造影增强表现特征.根据病理结果分为前列腺增生组与前列腺癌组,并比较两组造影表现差异.结果 与前列腺增生造影增强表现相比,前列腺癌造影增强表现为快速增强,高增强,不均匀增强,增强后病变边界清楚,增强后存在不对称血管结构,快速消退,部分病灶内存在无增强区并且病灶内增强区与无增强区交界处不光滑,连续性差.结论 前列腺癌与前列腺增生造影增强表现存在显著差异,通过观察造影增强表现有助于前列腺癌与前列腺增生的鉴别诊断.

Evaluation of contrast-enhanced transrectal ultrasound in differential diagnosis of prostate cancer and benign prostatic hyperplasia

Objective To evaluate the application of contrast-enhanced transrectal ultrasound ( CETRUS) to identify prostate cancer(PCa) from benign prostatic hyperplasia(BPH). Methods A total of 86 patients with focal prostatic disease detected by trans rectal ultrasound(TRUS) were enrolled in this study.Each patient underwent grey-scale TRUS, CE-TRUS, and targeted-biopsy of prostateunder ultrasound guidance successively on the same day. The criteria of perfusion pattern would be statistically analyzed among groups divided by pathological findings. Every patient's images of CE-TRUS were observed and features of perfusion pattern were recorded by two doctors who were blind to any clinical data of patient.Then these features recorded by two doctors were compared, if the features were coherent, they would be recorded as final results,and otherwise two doctors would consult till the features were coherent. Results Compared with BPH group, the enhancement features of PCa group were rapid enhancement, increased enhancement, heterogeneous enhancement, well-defined boundary of lesion after enhancement, asymmetric appearance of intraprostatic vessels, rapid decrease, perfusion defect areas within lesions and the roughly discontinuous juncture between enhancement and no enhancement area within lesions. Conclusions There was significant difference in enhancement pattern between BPH and PCa groups, observing enhancement pattern could help to identify prostate cancer from benign prostate hyperplasia.