经直肠彩色多普勒超声对前列腺癌的诊断价值

目的　探讨经直肠彩色多普勒超声检查法对前列腺癌的诊断价值。方法　对 13 5例临床疑有前列腺癌的病人行经直肠灰阶超声及彩色多普勒超声检查 ,利用彩色直方图计算软件测得前列腺内异常血流增多区域的彩色血流面积占所选区域面积的百分比(theblackandwhitecolorratio ,BCR) ,并与其整个前列腺内血流BCR比较。每例患者均行经直肠超声引导下前列腺穿刺活检。结果　13 5例病人经前列腺穿刺病理证实前列腺癌 73例 ,前列腺增生症 5 0例 ,前列腺炎 12例。经直肠灰阶超声检查发现异常回声 84例 ,前列腺癌 5 1例 ,前列腺增生症 2 6例 ,前列腺炎 7例。经直肠彩色多普勒超声检查发现异常血流增多的 73例 ,前列腺癌 5 6例 ,其中 12例为灰阶超声无异常发现的位于内腺的前列腺癌。前列腺增生症 11例 ,前列腺炎 6例。经直肠灰阶超声及彩色多普勒超声检查对诊断前列腺癌的敏感性、特异性、阳性预测值分别为 70 .0 % ,46.8% ,60 .7%和 76.7% ,72 .6% ,76.7%。结论　经直肠彩色多普勒超声检查应列为前列腺癌的常规检查 ,这对提高前列腺癌的检出率 ,特别对位于内腺的前列腺癌有重要意义

Evaluation of Color Doppler Transrectal Ultrasonography in Prostate Cancer

Objective To evaluate the value of color Doppler transrectal ultrsonography in the diagnosis of prostate cancer.Methods One hundred thirty-five patients suspected with prostate cancer by urologist underwent transrectal ultrasonography using gray-scale and color Doppler scanning. The black and white color ratio (BCR,%) of all abnormal color Doppler area were obtained with color histogram software, then the BCR was compared with its total prostate's. Biopsies were performed on each patient. Results Cancer was found on biopsy in 73 patients, benign prostatic hypertrophy(BPH) in 50 patients, and prostatitis in 12 patients. Total 84 patients were found abnormal echogenicity on gray-scale scanning, prostatic cancer in 51cases, BPH in 26 cases and prostatitis in 7 cases. The sensitivity, specificity and positive predictive value was 70.0%,46.8% and 60.7% respectively. 73 patients were detected abnormal flow area on color Doppler scanning, prostatic cancer in 56 cases, twelve of them were nothing findings on gray-scale image. BPH in 11 cases, and in 6 cases. The sensitivity, specificity and positive predictive value was 76.7%,72.6% and 76.7% respectively.Conclusion Color Doppler sonography should become a routine part of transrectal ultrasonography of the prostate gland.It is helpful to increase detection of prostatic cancer, espetially located in transitional zone.