超声造影在良性前列腺增生和前列腺癌鉴别诊断中的价值

Value of contrast-enhanced ultrasound in differential diagnosis of benign prostatic hyperplasia and prostate cancer

目的探讨良性前列腺增生和前列腺癌超声造影的强化特征,超声造影在二者诊断与鉴别诊断中的应用价值。方法对经病理证实的50例良性前列腺增生和30例前列腺癌患者术前行超声造影检查。观察前列腺增生和前列腺癌的强化特征,并以声学定量软件绘制前列腺癌、前列腺增生的时间-强度曲线(TIC),分析TIC形态和定量参数变化特征。结果前列腺癌强化不均匀,其病变部位呈明显快速强化,TIC形态上升支较为陡直,呈快上型;前列腺增生呈均匀强化,上升支较为低平。声学定量参数比较:前列腺癌、前列腺增生在始增时间、达峰时间、峰值强度、强度变化以及单位时间内灌注强度变化率之间比较差异均有统计学意义,在基础强度间比较差异无统计学意义。结论超声造影检查能够显示前列腺增生和前列腺癌的血供情况及强化特征,对前列腺癌病灶的显示和诊断起着重要作用。

Objective To investigate the contrast-enhanced features of benign prostatic hyperplasia （BPH） and prostate cancer （PCa） and the application value of contrast-enhanced ultrasound （CEUS） in differential diagnosis of BPH and PCa. Methods Fifty cases of BPH and 30 cases of PCa confirmed by histopathology were examined by CEUS before operating or biopsy. Their characteristics of CEUS were observed, and their TIC was described by acoustic quantified software, the change characteristics of TIC morphous and quantitative parameter were analyzed. Results Inhomogeneous and rapid enhancement were found in PCa group, and TIC showed quick-up types, while homogeneous enhancement was found in BPH group, TIC showed low-up types. There was significant difference of acoustic quantified parameters among the time of initial enhancement and peak enhancement, the intensity of peak enhancement, the change rate of strength in prostate cancer group and prostatic hyperplasia group, while there was no significant difference of the intensity of fundament between the two groups. Conclusion CEUS can reflect the blood supply and enhancement characteristics of BPH and PCa, it has significant importance in detection and diagnosis of prostate carcinoma lesions.