前列腺外周带良性病变的声像图特征及阻力指数研究

Investigation of ultrasonographic feature and resistive index in benign disease of prostatic peripheral zone

目的探讨声像图特征及阻力指数(RI)在前列腺外周带良恶性病变鉴别诊断中的价值。方法经超声引导下穿刺活检病理确诊的前列腺外周带良性病灶35例,观察病灶回声强度,形态边缘,彩色血流丰富程度,并计算病灶体积,测定小动脉的阻力指数。将结果与35例经穿刺活检确诊的前列腺癌进行对照分析。结果(1)良性病变多表现为结节状,边缘清楚(71.4%);前列腺癌多表现为片状,边缘不清(60.0%),两组间差异有明显的统计学意义(P<0.01)。(2)良性病变的体积(2.12±1.52)ml,显著低于前列腺癌的体积(4.34±2.51)ml(P<0.01)。(3)在良恶性病变中的彩色血流分布没有明显的差异(P>0.05)。两组间阻力指数比较,差异有明显的统计学意义(P<0.01)。结论前列腺外周带良性病变和前列腺癌的回声强度及彩色血流分布相似,但两者在声像图上的形态、病灶体积和阻力指数方面均有显著差异,因此二维声像图特征及阻力指数在前列腺外周带良恶性病变的鉴别诊断中具有重要的作用。

Objective To evaluate the value of ultrasonographic feature and Resistive Index in the differentiated diagnosis of benign and malignant disease of prostatic peripheral zone. Methods Thirteen-five cases with benign diseases of prostatic peripheral zone were all identified by pathological analysis. The pixel of color flow and RI, the shape and the volume of the lesions were observed and measured by analysis of ultrasound imaging, and then the results were compared with those of 35 cases with prostate cancer diagnosed by pathological analysis. Results （1）Most of benign lesions were nodular and well defined margin lesions （71.4%）, but prostate cancer mainly presented patch-like and ill-defined margin lesions （60.0%）. The differences in morphology between the two groups were significant（P〈0.01）. （2） The average volume（2.12±1.52）ml of benign lesion was significantly less than that（4.34±2.51）ml of prostate cancer （P〈0.01）. （3） There was no statistic difference in the pixel of the color flow between the two groups （P〈0.01）. The average RI of benign lesion was significantly less than that of prostate cancer （P〈0.01）. Condusion Although the color flow signal intensities and echogenicity on ultrasound imaging were similar between benign lesion of prostatic peripheral zone and prostate cancer, obvious differences in the shape, the volume and resistive index were all detected between two groups. Combination of sonography and RI might play an important role in differentiated diagnosis of benign and malignant lesions of prostatic peripheral zone.