经直肠超声弹性成像在前列腺癌诊断中的应用

目的 探讨经直肠超声弹性成像(TRE)在前列腺癌诊断中的应用价值。方法 118例疑诊前列腺癌患者行经直肠超声成像(TRUS)、TRE及超声引导下经直肠前列腺穿刺活检，以穿刺活检结果为金标准，分析TRE对前列腺癌的诊断价值。结果 TRE与TRUS对于诊断前列腺周围区癌灶的敏感性分别为73.6％、52.8％，特异性分别为72.7％、71.9％,二者敏感性差异有统计学意义;TRE与TRUS对于诊断位于前列腺中央区及移行区癌灶的敏感性分别为57.1％、57.1 ％，特异性分别为71.3％、70.7％,其差异均无统计学意义。癌组织应变比值(strain ratio，SR)平均值为27.35±35.20，良性病灶SR平均值为2.91±0.55，二者差异有统计学意义。由ROC曲线可知，当SR切点值为3.6时曲线下面积为0.80,其预测前列腺癌的敏感性为85.7％，特异性为67.7％。结论TRE的应用可以提高前列腺癌的诊断率;TRE对于诊断位于前列腺周围区的病灶具有较高敏感性;以SR 3.6作为切点值，对于诊断前列腺癌具有较高的敏感性及特异性。

Evaluation of ultrasound elastography in the diagnosis of prostate cancer

Objective To evaluate the application of transrectal ultrasound elastography (TRE) in the detection of prostate cancer(PCa).Methods One hundred and eighteen patients with suspected PCa were enrolled in this study.Each patient underwent transrectal ultrasound (TRUS), TRE and sonography guided prostatic biopsy on the same day.The accuracy rate of PCa detection using TRE were compared with the pathology results.Results Patients with PCa were detected in 62 of the 118 patients,including 48 cases by TRE and 38 cases by TRUS.The sensitivity for TRE (73.6％) was significantly higher than that of TRUS (52.8％) in periurethral zone(P ＜0.05).The sensitivity and specificity for strain ratio(SR) in predicting PCa were 85.7％ and 67.7％ respectively(cut off value：3.6,area under the curve 0.8, P ＜0.01,95％CI [0.68 - 0.92]).Conclusions TRE can detect PCa in the periurethral zone with good accuracy and has potential to increase ultrasound-based PCa detection rate.