经直肠超声诊断慢性前列腺炎

Transrectal Ultrasound:An Applicable Diagnostic Approach to Chronic Prostatitis

目的:探讨经直肠超声诊断慢性前列腺炎的可能性。方法:2000年9月～2006年5月本中心行经直肠超声检查,同时行EPS检查诊断慢性前列腺炎3500例。结果:2279例(65.1%)前列腺内腺回声减低,呈散在低回声,有不均匀回声光点,边缘不光滑;1084例(31.0%)前列腺体积增大,包膜清晰、完整,内外腺交界处见增强斑状回声,其大小和分布不一,内腺边缘伴钙化;137例(4.0%)声像图表现不明显;391例(11.2%)同时伴有精囊炎声像改变,表现为精囊界限不清,内部回声不均匀。EPS白细胞,132例(3.8%)<10个/HP,2156例(61.6%)为10～19个/HP,1212(34.6%)例≥20个/HP。结论:经直肠超声检查诊断慢性前列腺炎操作简单,患者痛苦小,容易接受,如与EPS检查结合,可以对慢性前列腺炎的诊断提供更加明确的依据。对于部分因惧怕疼痛而拒绝行EPS检查的患者,经直肠超声可以部分代替EPS检查。

Objective： To assess the application value of transrectal ultrasound （TRUS） in the diagnosis of chronic prostatitis. Methods： TRUS and examination of prostatic secretion （EPS） were used in the diagnosis of 3 500 cases of chronic prostatitis from Septembor, 2000 to May, 2006. Results： Lower resonance of the inner gland, low-level echo, uneven echo light spots, incomplete out-lines and unsmoeth borderlines were found in 2 279 cases （65.1%）, and the enlarged prostate in 1 084 cases （31.0%）, with clear integrated amicula and enhanced echogenic spots at the juncture of the external and inner gland. No obvious changes were noted in 137 cases （4.0%）, and in another 391 cases （ 11.2% ） were detected alteration of the acoustic image of cystespermitis and blurred margins and uneven echoes of the seminal vesicle. The WBC count in EPS was 〈 10/HP in 132 cases （3.8%）, 10-19/HP in 2 156 cases （61.6%） and ≥ 20/HP in 1 212 cases （34.6%）. Conclusion： TRUS, as a diagnostic means for chronic prostatitis, can be easily performed and causes little pain and therefore is readily accepted by patients. Combined with EPS, TRUS can provide more deftnite diagnostic evidence, and for those who are afraid of pain and reject EPS, it is a desirable alternative in the diagnosis of chronic prostatitis.