实时组织弹性成像应变指数在前列腺周围区病灶的鉴别诊断价值

Diagnostic Value of Strain Index in Prostate Peripheral Zone Lesions by Real-time Tissue Elastography

目的评估实时组织弹性成像应变指数(SI)在前列腺周围区病灶鉴别诊断中的价值。方法对83例可疑前列腺癌患者行经直肠实时组织弹性成像(TRTE)定量分析,分别获取病灶整体SI(ASI)及病灶局部SI(PSI),与病理结果对照,比较ASI与PSI在良恶性病灶鉴别诊断中的价值,并评价Gleason评分对SI的影响。结果 ASI与PSI诊断前列腺周围区良恶性病灶的ROC曲线下面积分别为0.62(P=0.06)和0.92(P=0.00)。当最佳PSI值为17.44时,诊断的敏感性为74.5%,特异性为83.3%。在PSI>17.44和PSI<17.44两组之间,肿瘤Gleason分数的差异无统计学意义(P>0.05)。结论 PSI有助于前列腺周围区良恶性病灶的鉴别诊断。

Objective To investigate the value of strain index（SI）by transrectal real-time tissue elastography（TRTE）for differentiation of the prostate peripheral zone lesions.Methods Totally 83 patients with suspected prostate cancer underwent the quantitative analysis by TRTE examination.The SI of total lesions（ASI）and peak elasticity in lesion（PSI）were calculated,and the pathologic findings were compared.Then the values of ASI and PSI in the differential diagnosis of prostate lesions were assessed.The influence of Gleanson scores on SI was evaluated.Results The area under the Receiver Operating Characteristic curves（or ROC curves）of ASI and PSI were 0.62（P=0.06）and 0.92（P=0.00）respectively for the differential diagnosis of prostate peripheral lesions.When a cutoff point of 17.44 was used,PSI had a sensitivity of 74.5% and a specificity of 83.3%.Gleason scores showed no significant difference between PSI〈17.44 group and PSI〉17.44 group（P〉0.05）.Conclusion PSI is helpful for the differential diagnosis of prostate peripheral zone lesions.