经直肠超声对弥漫浸润型前列腺癌与前列腺增生的鉴别价值

目的探讨经直肠超声（TRUS）在弥漫浸润型前列腺癌（PCA）与前列腺增生（BPH）鉴别诊断中的应用。方法对穿刺活检病理学证实且超声分型为弥漫浸润型的18例PCA患者及38例BPH患者采用TRUS检查，观察前列腺的形态、边界、内部回声、血流情况，测量动脉血流阻力指数（RI）。结果弥漫浸润型PCA患者66．7％前列腺边界不规则，77．8％内外腺界线不清晰，50．0%内部回声极不均匀，BPH则分别为5．3％、26．3％和5．3％。两组前列腺内血流丰富程度、动脉RI无明显差异（P〉0．05）。结论前列腺的边界、内外腺关系及内部回声的均匀程度对弥漫浸润型PCA与BPH的鉴别诊断具有重要价值，前列腺内的血流丰富程度及动脉RI对两者无鉴别诊断意义。

Transrectal Ultrasound in Differentiation of Diffuse Invasive Prostate Carcinoma and Benign Prostate Hyperplasia

Objective To discuss the diagnostic value of transrectal ultrasound(TRUS)in differentiation of diffuse invasive prostate carcinoma(PCA)and benign prostate hyperplasia(BPH).Methods A total of 56 patients including with 18 PCAs and 38 BPHs which were diagnosed by histopathologic findings,were detected by TRUS.The 18 PCAs were classified as diffuse invasive type by TRUS.Prostatic modality,borderline,inner echoes and color Doppler imaging were generally observed and simultaneouly artery RI values were measured.Results Irregular borders were found in 12 diffuse invasive PCAs(66.7%)and 2 BPHs(5.3%).Unclear borders between inner and outer glands were found in 14 PCAs(77.8%)and 10 BPHs(26.3%).And extremely inhomogenous echoes were found in 9 PCAs(50.0%)and 2 BPHs(5.3%).No obvious significance was found in color Doppler imagings and RI values between the two groups.Conclusions Prostatic borders,inner echoes and borders between inner and outer glands are quite important in the differentiation of diffuse invasive PCA and BPH.Color Doppler imaging and RI values are useless for the differentiation.