超声造影诊断前列腺增生症的临床意义

目的对比分析正常及增生前列腺的各项超声造影参数,探讨超声造影对前列腺增生症诊断的临床意义。方法回顾性分析前列腺增生症组(60例)与正常组(30例)的前列腺超声造影检查,观察前列腺内、外腺造影强化特征,应用机载软件绘制感兴趣区的时间-强度曲线得出造影参数:造影剂达到时间(AT)、峰值强度(P)、达峰时间(Tp)、曲线下面积(AUC)、平均渡越时间(MTT)及完全消退时间(ET),对比前列腺增生组与正常组内、外腺的超声造影参数,分析各参数与前列腺增生的相关性。结果①正常组外腺AT、ET较内腺略快,但差异无统计学意义;外腺P明显高于内腺,Tp明显早于内腺,AUC、MTT小于内腺,差异均有统计学意义(均P0.05);②前列腺增生组内腺AT早于外腺,Tp、ET晚于外腺,但差异无统计学意义;内腺P明显高于外腺,AUC明显大于外腺,MTT长于外腺,差异均有统计学意义(均P0.01);③前列腺增生组外腺AT、Tp均明显晚于正常组,但P高于后者,MTT、ET均长于后者,差异均有统计学意义(均P0.05);AUC两组比较差异无统计学意义;④前列腺增生组内腺AUC显著大于正常组,MTT、ET较正常组长,P高于正常组,差异均有统计学意义(P0.01或P0.05),AT、Tp两组比较差异无统计学意义。结论前列腺增生超声造影表现为内、外腺P增高,AUC增大,MTT延长,ET延迟及外腺AT、Tp延迟,可以作为诊断前列腺增生的影像学依据,在前列腺疾病鉴别诊断中将发挥重要作用。

Clinical meaning of contrast-enhanced ultrasound parameters for diagnosing benign prostatic hyperplasia

Objective To investigate the clinical meaning of contrast-enhanced ultrasound （CEUS） in diagnosis of benign prostatic hyperplasia （BPH） by comparing the CEUS parameters between BPH and normal prostate. Methods Sixty BPH patients （BPH group ） and thirty normal persons without prostate diseases （normal group） were analyzed by CEUS previously. The enhancement characteristics of inner and external gland on CEUS were observed. The time-intensity curves in regions of interest were described by using ACQ software. The following parameters were obtained： arrival time （AT）, peak intensity （P）, time to peak （TP）, area under the curve （AUC）, mean transit time （MTI＇） and extinction time （ET）. The CEUS parameters of inner and external gland were compared between BPH group and normal group. The correlations between BPH and the CEUS parameters were evaluated. Results ①In normal group, AT and ET of external gland were fast than those of inner gland, there was no significant difference. P of external gland was higher than that of inner gland, Tp was early, AUC, MTI were smaller, there was significant difference （P〈0.05）. ②In BPH group, AT of inner gland was early, TP and ET were later, there was no significant difference, P, AUC, MTr of inner gland were higher than those of external gland, there was significant difference（P〈0.01 ）. ③Comapred with normal group, AT and Tp of external gland were later, MTI＇, ET and P in BPH external gland were significantly higher, there was significant difference（P〈0.05 ）. There was no significant difference of AUC between the groups. ④In inner gland, MTF, ET, AUC and P in BPH group were also significantly higher than the normal group. There was significant difference（P〈0.01 or P〈0.05 ）, there was no signifiant difference of AT and Tp between the groups. Conclusion Among these significantly changed parameters, the increases of P, MTF, ET and AUC in inner and external gland and AT, Tp in external gland are most likely related to BPH. These parameters supplement an objective visual assessment to diagnose BPH.