经直肠超声造影在前列腺靶向穿刺活检中的价值

目的探讨经直肠超声（transrectalultrasound,TRUS）造影（TR-CEUS）技术对前列腺癌的诊断价值。方法对60例临床诊断可疑前列腺癌患者行TR-CEUS及前列腺穿刺活检术。观察病灶造影灌注模式,对异常增强结节进行靶向穿刺、标记送检。同时将结果与49例非造影组前期常规11点穿刺比较,观察其诊断效率。结果 60例患者中10例弥漫型前列腺癌呈快速不均匀增强,18例结节型前列腺癌中共观察35个癌结节,呈高增强结节18个、等增强结节12个、低增强结节5个。前列腺增生32例,其结节多为均匀性高增强。造影假阳性7例,假阴性3例。靶向穿刺活检诊断前列腺癌28例,诊断率（46.67%）高于11点穿刺（28.57%）。结论 TR-CEUS是评价前列腺良、恶性病变的有效方法,同时可以指导靶向穿刺活检,提高穿刺准确效率及减少穿刺针数。

Significance of contrast-enhanced ultrasound in the transrectal prostate targeted biopsy

Objective To investigate the significance of contrast-enhanced ultr~tsound （CEUS） in the transrectal prostate targeted biopsy. Methods A total of 60 patients with clinically suspec- ted prostate cancer were examined with CEUS and performed transrectal ultrasound guided biopsy of the prostate. The target punctures were implemented at the region with contrast suspicious, and were pathologically diagnosed. Contrast enhancement pattern of the prostate nodules were observed and compared with pathology results. Results 60 cases underwent TR-CEUS, 10 cases of them were asymmetrical suffusion enhance and 18 cases of the nodule including 35 nodules which flow sig- nals within the lesions of the nodular were respectively shown as 18 increased, 12 equal, 5 decreased, and 32 cases of benign prostatic hyperplasia, the nodules perfusion course was homogeneously enhanced. 7 ca- ses were false positive and 3 cases were false negative by CEUS. Puncture targeted biopsy diagnosed pros- tate cancer in 28 patients （46.67%）, which was higher than the rate 28.57% of a systematic ll-core biopsy diagnosis. Conclusions TR-CEUS could serve as one of the effective ways as differential di- agnosis between benign and malignant prostate disease. It can also be used to guide the prostate bi- opsy for improving the accurate rate and reduce needle number.