尿道周围前列腺组织弹性模量与良性前列腺增生患者IPSS的相关性研究

目的 应用剪切波弹性成像(SWE)获得尿道周围前列腺组织弹性模量,探讨其与良性前列腺增生(BPH)患者国际前列腺症状评分(IPSS)的相关性.资料与方法 75例BPH患者行IPSS后,对患者前列腺行经直肠SWE检查尿道周围前列腺组织的平均弹性模量,分别测量尿道上部、中部、下部的A区(紧邻尿道)和B区(距尿道2mm处)弹性模量平均值.根据IPSS结果将患者分为轻度组、中度组和重度组,比较各组尿道周围前列腺组织弹性模量差异,评价弹性模量与IPSS的相关性.选择17例正常男性作为对照.结果 BPH患者轻度组36例,中度组32例,重度组7例.正常组、轻度组、中度组与重度组前列腺周围组织弹性模量值分别为:上部A区( 16.21±2.54)、(20.71±2.92)、(26.79±3.45)、(31.74±4.13);上部B区(16.90±3.44)、(23.25±3.52)、( 28.72±3.29)、(38.31±3.81);中部A区(15.78±1.75)、(21.97±3.79)、(28.94±4.46)、(33.46±4.41);中部B区( 16.23±1.97)、(22.52±3.61)、(30.28±3.59)、(38.66±6.01);下部A 区( 17.93±7.03)、(23.23±4.99)、(27.71±3.71)、(40.37±7.89);下部B区(16.45±3.51)、(23.12±5.65)、(29.16±3.44)、(42.18±1.91).各区弹性模量与IPSS呈显著正相关(r=0.727～0.856,P＜0.01).结论 尿道周围前列腺组织弹性模量与IPSS显著相关,因此SWE可以作为无创评估膀胱出口梗阻程度的新方法.

Correlation Between Elastic Modulus of Periurethral Prostatic Tissue and IPSS in Patients with Benign Prostatic Hyperplasia

Purpose To detect the elastic modulus of periurethral prostatic tissue by using shear wave elasticity imaging(SWE) and to investigate the correlation between elastic modulus of periurethral prostatic tissue and international prostate symptom score(IPSS) of patients with benign prostatic hyperplasia(BPH).Materials and Methods Seventy-five patients with BPH underwent transrectal prostate ultrasound with SWE to detect the average elastic modulus of the periurethral prostatic tissues after IPSS score.The elastic modulus of the upper,middle and lower areas near the urethra(A region) and 2 mm away from the urethra(B region) were detected.All patients were divided into mild group,moderate group and severe group according to IPSS scores.The statistical difference in elastic modulus among three groups was compared,and the correlation between the elastic modulus of periurethral prostatic tissue and IPSS was also analyzed.Seventeen health males were selected as controls.Results There were 36 patients in mild group,32 in moderate group and 7 in severe group.The elastic modulus of the periurethral prostatic tissues in normal group,mild group,moderate group and severe group were(16.21±2.54),(20.71±2.92),(26.79±3.45),(31.74±4.13) for upper area of A region,respectively;(16.90±3.44),(23.25±3.52),(28.72±3.29),(38.31±3.81) for B region,respectively;(15.78±1.75),(21.97±3.79),(28.94±4.46),(33.46±4.41) for middle area A region,respectively;and(16.23±1.97),(22.52±3.61),(30.28±3.59),(38.66±6.01) for B region,respectively;(17.93±7.03),(23.23±4.99),(27.71±3.71),(40.37±7.89) for inferior area of A region,respectively;(16.45±3.51),(23.12±5.65),(29.16±3.44),(42.18±1.91) for B region,respectively.Significant correlation between the modulus and the IPSS was detected with the coefficient ranged 0.727 to 0.856(P < 0.01).Conclusion The elastic modulus of periurethral prostatic tissue obtained by SWE has significant correlation with the IPSS.SWE is verified to be a promising,novel noninvasive testing method to assess the degree of bladder outlet obstruction.