经直肠二维、彩色及能量多普勒超声诊断前列腺癌及其与微血管密度对照研究

目的：通过与病理微血管密度（MVD）对照研究，探讨经直肠二维（2D），彩色多普勒（CDFI）及能量多普勒超声（PDU）诊断前列腺癌的价值。方法：回顾性分析23例前列腺癌，21例前列腺增生患者的经直肠2D、CDFI及PDU图像。通过分析2D声像图对前列腺的形态学记录；CDFI对前列腺内动脉血流显示并检测RI；PDU对前列腺微血管灌注显示并估计血流分级。并采用免疫组化（SP）法检测对应标本内的MVD表达。结果：①经直肠超声（TRUS）诊断的23例前列腺癌和21例前列腺增生，超声诊断正确率分别为82.6%（19/23），90.5%（19/21）。2D结合CDFI及PDU能有效提高诊断正确率。②前列腺癌组PDU血流分级，RI，MVD均高于前列腺增生组，两组各项指标间差异均有统计学意义（P<0.001），PDU血流分级与MVD有良好的正相关关系。结论：经直肠2D结合CDFI、PDU能显示前列腺内部形态结构，也能反映前列腺微血管灌注情况并检测血流RI；与MVD表达对比研究，可以从不同角度反映前列腺癌血管生成情况，对评价其生物学行为具有重要意义。

Comparative value of transrectal color & power Doppler ultrasonography with microvascular density of histopathology by immunochemistry in diagnosing prostate cancer

Objective： To explore the value of transrectal uhrasound（TRUS）, color Doppler flow imaging （CDFI） and power Doppler ultrasonography （PDU） in diagnosing prostate cancer, and correlated with the expression of microvasealar density（MVD） in histopathology by immunochemistry. Materials and Methods： In 23 cases of prostate cancer and 21 cases of prostate hyperplasia, the images acquired by two-dimensional （2D） TRUS, CDFI and PDU were analyzed retrospectively. The morphology of prostate was analyzed by 2D sonography. The arterial flow signal of prostate was displayed by CDFI, and the resistance index（RI） was recorded. The classification of arterial flow in the prostate was performed by PDU. And then the MVD expression was detected by immunohistochemistry technique （SP method）. Results： （1）The accurate rate of TRUS sonography in diagnosing prostate cancer and prostate hyperplasia was 82.6%（19/23） and 90.5%（19/21） respectively. The diagnostic accuracy was increased by 2D sonography combined with CDFI and PDU. （2）The classification of arterial flow, RI and MVD expression in prostate cancer were higher than those in prostate hyperplasia with significant difference（P〈0.001）. The classification of arterial flow by PDU was positively interrelation with MVD expression by immunohistochemistry in prostate cancer. Conclusions： The morphology of prostate was well displayed by 2D TRUS combined with CDFI and PDU, also the classification of arterial flow and RI in prostate were detected. Correlated with the MVD expression, the vascular growth in prostate cancer was confirmed in different aspects. It played a key role in evaluating the biology of prostate cancer.