超声微泡造影对前列腺癌的诊断价值研究

Value of Contrast-enhanced Ultrasound in Diagnosis of Prostate Cancer

目的探讨超声造影(CEUS)技术对前列腺癌的诊断价值.方法对59例临床诊断可疑前列腺癌患者,行经直肠超声(TRUS)造影及前列腺穿刺活检术.观察病灶造影增强模式,对异常增强结节进行靶向活检、标记送检,并与病理结果对比,研究CEUS在引导活检的靶向应用效果,观察其诊断效率.并应用QLab软件对癌结节行感兴趣区域(ROI)的时间强度曲线(TIC)分析,研究前列腺癌病灶变化规律.结果 59例患者行CEUS检查后,穿刺活检病理诊断22例(37.3%)前列腺癌,7例非典型增生,前列腺增生30例.造影假阳性9例,假阴性3例.22例中不均匀弥漫增强10例,结节型前列腺癌共观察35个癌结节,呈高增强18个结节,等增强12个结节,低增强5个结节.结论前列腺癌病灶造影增强模式多样,同一例前列腺癌可有不同增强模式结节.CEUS能客观地评价前列腺内病灶的血流情况.同时可以指导进行靶向穿刺活检,提高穿刺准确率.

Objective To evaluate the value of contrast-enhanced ultrasound（CEUS）in the diagnosis of prostate cancer（PCA）.Methods Atotal of 59 patients with clinically suspected PCA were examined with CEUS and performed transrectal ultrasound guided biopsy of the prostate.The target puncture was implemented at the suspicious region,and were pathologically diagnosed.Contrast enhancement pattern of the prostate nodes were observed and compared with pathologica result to evaluate the accurate rate of the PCA on contrast enhanced ultrasound（CEUS）in targeted biopsies.The real-time observation of dynamic perfusion of malignant nodes and analysed time-intensity curve（TIC） in the region of interest（ROI）were performed.Results According to pathological results,PCA was detected in 22（37.3%）of the 59 patients,30 cases were benign prostate hyperplasia,7 cases were prostatic int raepithelial neoplasia.9 cases were false positive and 3 cases were false negative by CEUS.22 cases were proved PCA,of which 10 asymmetrical suffusion enhance and others the nodular including 35 nodules.Flow signals within the lesions of the nodular were respectively shown as 18 increased,12 equal,5 decreased.Conclusions There are diverse flow signals in the same case,so various enhaced modes can be shown in the PCA lesions.CEUS can be used to evaluate the presence of vasculature within the lesions of PCA and to guide the prostate biopsy for improving the accurate rate.