经直肠超声造影鉴别老年前列腺良恶性结节

Transrectal contrast-enhanced ultrasound in the differentiation of benign and malignant nodules of prostate in older men

目的应用经直肠超声造影及穿刺活检病理分析,探讨前列腺良恶性结节的超声造影特点。方法使用SonoVue对135例经直肠超声检出的前列腺异常结节患者进行造影检查,观察良恶性结节的常规超声及超声造影表现,利用Q-Lab软件对良恶性结节的组织造影参数进行对比分析。结果经直肠超声引导前列腺穿刺活检检出异常结节174个,恶性结节77个,良性结节97个;55个恶性结节位于外腺区,69个良性结节位于内腺区。71.43%(55/77)的恶性结节超声造影表现为"快进快出"的高增强。88.66%(86/97)内外腺良性结节表现为与周围前列腺组织同步灌注的均匀增强。结论经直肠超声造影在鉴别前列腺结节良恶性及判定病变部位具有良好的临床应用价值。

Objective To explore the features of benign and malignant prostate nodules based on the transrectal contrast-enhanced ultrasound（CEUS）and transrectal ultrasound-guided biopsy pathological findings.Methods In 135 patients of abnormalities within the prostate nodules,transrectal CEUS was performed with administration of venous injection of SonoVue.The characteristics of routine ultrasound and CEUS in the benign and malignant nodules were observed.A comparative analysis of variables in the tissues of benign and malignant nodules was performed with Q-LAB software.Results In 174 of abnormal nodules with transrectal ultrasound-guided biopsy,77 malignant nodules and 97 benign nodules were detected,and 55 of malignant nodules located in the outer gland areas,whereas 69 of benign nodules located in the inner gland area.High-density enhancement with signal of fast washin and fast washout was found in 71.43%（55/77）of malignant nodules,while simultaneously homogeneous perfused enhancement was observed in 88.66%（86/97）of benign nodules inside and outside the gland.Conclusion Transrectal CEUS plays an important role in the differentiation of benign or malignant nodules of prostate and determination of extent of the lesions.