CAJ | 학술논문

目的探讨经直肠多普勒超声及超声造影检查鉴别前列腺良恶性结节的临床价值.方法应用彩色和能量多普勒超声(PDUS)及血流分析软件,记录52例患者共67个前列腺结节的峰值血流指数(PVI),比较不同超声条件下前列腺良恶性结节组问PVI的差异.经直肠超声造影检查观察结节及其周围腺体组织造影增强模式,并对外腺低回声病灶行穿刺病理检查. 结果52例患者超声检出前列腺恶性结节32个,良性结节35个,恶性结节PVI为0.38±0.16、良性结节0.24±0.10(P=0.0023);PDUS检测PVI分别为0.55±0.18、0.32±0.21(P<0.01),ROC曲线下面积0.817,95%,可信区间0.704～0.901.超声造影检查30个良性结节表现为与周围实质同步灌注,增强强度低于或接近周围实质;32个恶性结节表现为灌注早于周围实质,增强强度高于周围内外腺实质.结论 PDUS检测定量参数PVI是鉴别前列腺良恶性结节的有效指标,经直肠超声造影检查有助于前列腺外腺良恶性结节的鉴别诊断.
목적 탐토경직장다보륵초성급초성조영검사감별전렬선량악성결절적림상개치.방법 응용채색화능량다보륵초성(PDUS)급혈류분석연건,기록52례환자공67개전렬선결절적봉치혈류지수(PVI),비교불동초성조건하전렬선량악성결절조문PVI적차이.경직장초성조영검사관찰결절급기주위선체조직조영증강모식,병대외선저회성병조행천자병리검사. 결과52례환자초성검출전렬선악성결절32개,량성결절35개,악성결절PVI위0.38±0.16、량성결절0.24±0.10(P=0.0023);PDUS검측PVI분별위0.55±0.18、0.32±0.21(P<0.01),ROC곡선하면적0.817,95%,가신구간0.704～0.901.초성조영검사30개량성결절표현위여주위실질동보관주,증강강도저우혹접근주위실질;32개악성결절표현위관주조우주위실질,증강강도고우주위내외선실질.결론 PDUS검측정량삼수PVI시감별전렬선량악성결절적유효지표,경직장초성조영검사유조우전렬선외선량악성결절적감별진단.
Objective To investigate the value of transrectal Doppler and contrast-enhanced ultrasonography(CETRUS)to discriminate benign and cancerous nodules in prostate. Methods Fifty-five patients with hypoechoic lesions(35 biopsy-proven benign nodules and 32 prostate cancer nodules)in the prostate underwent Color and power Doppler uhrasonography(PDUS),and the parameter of peak vascularization index(PVI)in each prostate nodule was recorded and the differences of PVI in the benign and cancerous nodules were analyzed.CETRUS was then performed on all cases.The enhancement patterns of the lesions and their surrounding peripheral zone tissues were observed.After CETRUS,lesion-specific TRUS-guided biopsy and the routine sextant biopsy were performed subsequently. Results PVI of 32 prostate cancerous nodules and 35 prostate benign nodules were (0.38±0.16),(0.24±0.19),respectively,measured by color Doppler ultrasonography.And the former was significantly higher than the latter(P=0.0023).PVI of the cancerous nodules and the benign nodules were(0.55±0.18),(0.32±0.21)(P<0.01).Malignant lesions showed significant increased peak intensity and earlier arrival time compared with their surrounding outer gland tissue,while benign lesions showed nearly equal peak intensity and time to enhancement compared with their surrounding gland tissue by CETRUS. Conclusions PVI measured by PDUS was more effective than that measured by color Doppler to discriminate benign and cancerous nodules in prostate.CETRUS could be helpful in discriminatory performance of benign and cancerous nodules in prostate.