超声造影在前列腺周缘带结节良恶性鉴别诊断中的价值

Value of contrast-enhanced transrectal ultrasound in diagnosis of benign and malignant focal nodules in the peripheral zone of the prostate gland

目的评估超声造影在判断前列腺周缘带低回声结节良恶性中的价值。方法对108例临床怀疑前列腺癌的患者进行超声造影和经直肠前列腺穿刺活检,比较经直肠超声造影检查中前列腺癌和前列腺增生周缘带低回声结节超声造影的不同表现。结果 108例患者中,49例为前列腺癌,59例为前列腺增生。在63例患者的前列腺周缘带中发现低回声结节81个。其中,43例前列腺癌周缘带中低回声结节60个;20例前列腺增生周缘带低回声结节21个。前列腺癌周缘带结节超声造影表现为:高增强36个(36/60),低增强15个(15/60),等增强9个(9/60);45个(45/60)以"快进"为主要灌注模式。前列腺增生周缘带结节超声造影表现为:高增强2个(2/21),低增强5个(5/21),等增强14个(14/21),18个(18/21)以"慢进"为主要灌注模式。结论前列腺癌周缘带结节以快进和高增强为主,而前列腺增生周缘带结节则以慢进和等增强为主。超声造影有助于判断前列腺周缘带结节良恶性。

Objective To evaluate the value of contrast-enhanced transrectal ultrasound （CE-TRUS） in diagnosis of benign and malignant focal nodules in the peripheral zone of the prostate. Methods Total of 108 patients suspected of prostate cancer received CE-TRUS examination and transrectal ultrasound-guided prostate biopsy （TRUPB）. The enhancement characteristics of focal nodules in peripheral zone of prostate were compared between prostate carcinoma （PCa） and benign prostatic hyperplasia （BPH）. Results Of 108 patients, 49 cases and 59 cases were diagnosed as PCa and BPH respectively based on TRUPB. A total of 81 hypoechoic nodules were found in 63 patients including of 60 in 43 PCa and 21 in 20 BPH. The degrees of enhancement within the lesions were graded as hyper-enhanceme, hypo-enhancement and iso-enhancement. And 36 cases were hyper-enhancement, 15 cases hypo-enhancement and 9 cases iso-enhancement in Pca patients, whereas in BPH, 2 cases were hyper-enhancement, 5 cases hypo-enhancement and 14 cases iso-enhancement. Sum of 45 lesions showed fast-in in Pca patients and 18 nodules showed slow-in in BPH. Conclusion Malignant focal nodules in the peripheral zone of the prostate were characterized with hyper-enhancement and fast-in perfusion mode, while hyperplasia ones were iso-enhancement and slow-in under CE-TRUS examination. CE-TRUS examination was helpful in differentiating diagnosis of benign and malignant focal nodules in the peripheral zone of the prostate.