经直肠常规超声在前列腺实性结节良恶性鉴别诊断中的价值

目的探讨经直肠常规超声在前列腺结节定性诊断中的应用价值。方法对临床怀疑前列腺疾病患者行经直肠二维超声、彩色多普勒超声及能量多普勒超声检查，检出前列腺实性结节患者43例共55个结节，分析良恶性结节超声图像特征，并将结果与病理结果对照。结果55个实性结节病理证实33个恶性（恶性组）、22个良性（良性组）。恶性组与良性组比较，良恶性结节在发生部位上差异有统计学意义（P〈0．05）；而良恶性结节声像图在形态、边界、内部回声及血流分级上差异均无统计学意义（P〉0．05）。经直肠超声诊断前列腺癌的灵敏度、特异度、诊断准确度分别为60．6％、54．5％、58．2％。结论经直肠常规超声图像清晰，对前列腺结节分辨力高，在发现结节和定位诊断方面具有重要的临床应用价值，但前列腺良恶性结节声像图存在交叉重叠，经直肠超声对前列腺结节良恶性的鉴别价值有限。

Application of conventional transrectal ultrasound in the differential diagnosis of benign and malignant prostate solid nodules

Objective To investigate the application of conventional transrectal ultrasound in the diagnosis of pros- tate nodules. Methods Patients with suspected prostate diseases were examined using transrectal 2D ultrasound, color Doppler ultrasound and power Doppler sonography. Then 43 patients were diagnosed with prostate nodules, totaling 55 nodules. Their ultrasonic images were analyzed to differentiate the malignance of the nodules before comparison with path- ologica] results. Results Based on the pathological data, 55 malignant prostate solid nodules and 22 benign nodules were determined. Statistical differences were seen between benign and malignant groups as to the location of the nodules （ P 〈 0.05 ） , rather than sonographic morphology, boundary, internal echo and blood flow grade （ P 〉 0.05 ）. Transrectal ultrasound had 60.6% sensitivity, 54.5% specificity and 58.2% accuracy when applied for diagnosis of prostate cancer. Conclusion Conventional transrecta[ ultrasound can provide high - resolution images usefu｜ for diagnosing and locating nodules. However, due to image overlapping present in both benign and malignant prostate nodules, the application of transrectal ultrasound in the differential diagnose of prostate nodules was limited.