经直肠与经腹彩色多普勒超声诊断肥胖患者膀胱肿瘤的对比分析

Comparison of transrectal ultrasound with transabdominal ultrasound in fat sufferers with bladder tumor

目的探讨经直肠与经腹超声对肥胖患者膀胱肿瘤的诊断价值。方法采用自身对照的方法对87例肥胖患者的膀胱肿瘤行经直肠和经腹超声检查，并以膀胱镜及术后病理为标准，按肿瘤大小分为〈10mm、10-20mm、〉20mm三组，对比两种方法对各组肿瘤及肿瘤内血管检出率，比较两种方法对肿瘤分期的诊断符合率。结果经病理确诊膀胱肿瘤92个，经腹超声的诊断符合率79．3％，漏诊率17．4％，误诊率3．3％；经直肠超声的诊断符合率95．6％，漏诊率4．4％，误诊率0。两种方法在〈10mm组中的肿瘤检出率和肿瘤内血流检出率差异具有统计学意义（P〈0．05），在肿瘤分期中Ta、T1、T2期的诊断符合率差异具有统计学意义（P〈0．05）。结论经直肠超声在检出肥胖患者的膀胱肿瘤方面明显优于经腹超声。

Objective To discuss the diagnosis value of transrectal ultrasound and transabdominal ultrasound in fat sufferers with bladder tumor. Methods In own control, transabdominal and transrectal ultrasound were used to examine 87 fat patients with suspected bladder tumor. The tumors were confirmed by cystoscope and pathological section. They were divided into 3 groups according to the size： 〈 10 mm, 10-20 mm, and 〉20 mm, the detection rates of the tumors and blood flow in tumors, the diagnose accordance rates of the tumor stage of the two methods were analyzed. Results Of the 92 lesions pathologically confirmed to be bladder tumors,the diagnose accordance rate of transabdominal ultrasound was 79.3% ,missed diagnosis rate was 17.4%, misdiagnosis rate was 3.3%, while the diagnose accordance rate of transrectal ultrasound was 95.6%, missed diagnosis rate was 4.4%, misdiagnosis rate was 0. There was statistical significance on the detection rate of the tumor and blood flow in tumor of the two methods （P 〈0.05）. Also there was statistical significance on the diagnosis accordance rate of the tumor staging on Ta,T1, T2（ P 〈0.05）. Conclusions As to detecting bladder tumors in fat sufferers,transrectal ultrasound is obviously superior to transabdominal ultrasound.