经直肠超声造影联合剪切波弹性成像诊断前列腺良恶性病变的价值

  目的  分析经直肠超声造影(CETRUS)联合剪切波弹性成像鉴别诊断前列腺良恶性病变的价值。  方法  选取2020年5月~2021年12月我院收治的102例前列腺疾病患者，以经直肠超声(TRUS)引导前列腺穿刺活检为金标准，将其分为前列腺癌组(n=37)和前列腺增生组(n=65)，对所有患者进行经直肠超声造影联合剪切波弹性成像检查，比较两组患者的E_ration值和E_max值，比较不同方法的诊断准确度。  结果  前列腺癌组患者E_ration、E_max值明显高于前列腺增生组患者，差异有统计学意义(P < 0.05)；CETRUS联合剪切波弹性成像诊断前列腺良恶性病变的敏感度、特异性、准确率明显高于单一CETRUS检查，单一技术诊断(81.08%、80.00%、80.39% vs 56.76%、64.62%、61.76%，P < 0.05)；CETRUS联合剪切波弹性成像的曲线下面积为0.748(95%CI:0.534~0.760)，大于单一CETRUS曲线下面积0.685(95%CI:0.626~0.851)。  结论  经直肠超声造影联合剪切波弹性成像可通过杨氏模量值来反应组织的硬度，进而对前列腺良恶性病变进行诊断，在临床上具有一定的应用价值。 

Value of transrectal contrast-enhanced ultrasound combined with shear wave elastography in the differential diagnosis of benign and malignant prostatic lesions

  Objective  To analyze the value of transrectal contrast-enhanced ultrasound (CETRUS) combined with shear wave elastography in the differential diagnosis of benign and malignant prostate lesions.  Methods  A total of 102 patients with prostate diseases admitted to our hospital from May 2020 to December 2021 were selected, and divided into prostate cancer group (n=37) divided into prostate cancer group (n=37). All patients underwent transrectal contrast-enhanced ultrasound combined with shear wave elastography. E_ration value and E_max were compared between the two groups, and the diagnostic accuracy of different methods was compared.  Results  The E_ration value and E_max in prostate cancer group were significantly higher than those in benign prostatic hyperplasia group(P < 0.05). The sensitivity, specificity and accuracy of CETRUS combined with shear wave elastography in diagnosing benign and malignant prostate lesions were significantly higher than those of CETRUS alone(81.08%、80.00%、80.39% vs 56.76%、64.62%、61.76%, P < 0.05). The area under the curve of CETRUS combined with shear wave elastography was 0.748 (95%CI: 0.534-0.760), which was larger than that of CETRUS alone 0.685(95%CI: 0.266-0.851).  Conclusion  Transrectal contrast-enhanced ultrasound combined with shear-wave elastography can reflect tissue hardness through Young's modulus value, and then diagnose benign and malignant prostate lesions, which has certain clinical value.