| 李慎义,陈莉.经直肠超声造影鉴别诊断弥漫性前列腺癌[J].中国医学影像技术,2012,28(3):562~565 |
| 经直肠超声造影鉴别诊断弥漫性前列腺癌 |
| Contrast-enhanced ultrasound in the differential diagnosis of diffuse prostate carcinoma |
| 投稿时间：2011-04-28 修订日期：2011-07-18 |
| DOI： |
| 中文关键词: 前列腺肿瘤 前列腺增生 超声检查 造影剂 |
| 英文关键词:Prostatic neoplasms Prostatic hyperplasia Ultrasonography Contrast media |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨CEUS诊断弥漫性前列腺癌的临床应用价值。 方法 对经直肠穿刺病理证实的18例弥漫性前列腺癌患者(弥漫性前列腺癌组)及12例中重度良性前列腺增生(BPH)患者(BPH组)进行CEUS检查,观察造影增强表现,绘制时间-强度曲线(TIC),分析定量参数达峰时间(TTP)及达峰绝对值(DPI)的变化特征。并于CEUS前对前列腺被膜支动脉、尿道支动脉阻力指数(RI)进行检测。 结果 弥漫性前列腺癌组内腺TTP较BPH组内腺TTP短(P<0.01),而DPI较BPH组高(P<0.01)。弥漫性前列腺癌组外腺TTP较BPH组外腺TTP短(P<0.01),而DPI较高(P<0.01)。弥漫性前列腺癌组及BPH组前列腺内腺DPI均高于自身外腺(P<0.01),TTP均短于自身外腺(P<0.01)。18例弥漫性前列腺癌CEUS呈整体快速不均匀高增强,12例中重度BPH呈均匀有规律增强。弥漫性前列腺癌组被膜支动脉RI均值高于中重度BPH组(P<0.01)。以被膜支动脉RI=0.77为临界值,诊断弥漫性前列腺癌的敏感度89.01%、特异度83.25%。 结论 CEUS对弥漫性前列腺癌及中重度BPH的鉴别诊断具有重要价值。前列腺内被膜支动脉的RI有助于鉴别诊断。 |
| 英文摘要: |
| Objective To observe the clinical application value of contrast enhanced ultrasound (CEUS) in diagnosis of diffuse prostate carcinoma. Methods Eighteen diffuse prostate cancer patients (diffuse prostate cancer group) and 12 moderate or severe benign prostate hyperplasia (BPH) patients (BPH group) confirmed with transrectal biopsy underwent CEUS. The enhancement appearances were overviewed, the acoustic quantified parameter of time to peak (TTP) and derived peak intensity (DPI) were analyzed using time-intensity curve (TIC). The resistance index (RI) of capsular artery and urethral arteries of prostate gland were tested before CEUS. Results TTP of inner glands in diffuse prostate cancer group was shorter, while DPI was higher than those in BPH group (both P<0.01). TTP of external glands in diffuse prostate cancer group was shorter, while DPI was higher than those in BPH group (both P<0.01). DPI of in prostatic inner gland was higher, while TTP was shorter than that of outer gland in diffuse prostate cancer group and BPH group, respectively (both P<0.01). In diffuse prostate cancer group, the lesions hyper-enhanced as a whole rapidly and unevenly, while the lesions homogenously enhanced in BPH group. The average RI value for capsular artery in diffuse prostate cancer group was higher than that in BPH group (P<0.01). Taking RI=0.77 for capsular artery as the diagnostic value, the sensitivity in diagnosing diffuse prostate cancer was 89.01%, and the specificity was 83.25%. Conclusion Prostatic CEUS is quite important in the differentiation of diffuse invasive prostate carcinoma and moderate or severe BPH. RI of capsular artery is useful for the differentiation. |
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