经直肠三维超声对良性前列腺增生分度的诊断价值

Value of three-dimensional transrectal ultrasonography in the diagnosis of benign prostatic hyperplasia

目的探讨经直肠三维超声对良性前列腺增生分度的诊断价值。方法对104例前列腺增生患者应用经直肠三维超声进行常规扫查前列腺,测量前列腺全腺和内腺的上下径、左右径、前后径及前列腺内腺动脉阻力指数;采用三维体积自动测量技术测量前列腺全腺、内腺体积和重量,计算内外腺宽度之比、内外腺厚度之比及移行带指数。结果依据前列腺全腺重量将前列腺增生分为Ⅰ、Ⅱ、Ⅲ和Ⅳ四组,前列腺内腺重量、移行带指数、内外腺宽度之比、内外腺厚度之比以及前列腺内腺动脉阻力指数在四组间均为Ⅳ>Ⅲ>Ⅱ>Ⅰ(P<0.01),且与前列腺重量呈正相关(P<0.01),是前列腺增生分度较好的指标。结论前列腺体积及形态改变是超声诊断前列腺增生的重要依据,经直肠三维超声可以准确测量前列腺全腺及内腺体积,为前列腺增生分度提供最直观的形态学指标,移行带指数、内外腺宽度之比等前列腺参数有助于前列腺增生的分度。

Objective To evaluate the value of three-dimensional transrectal ultrasonography （3D-TRUS） in the graduation of benign prostatic hyperplasia （BPH）. Methods A total of 104 patients with BPH were checked by 3D-TRUS. The vertical diameter, transverse diameter, anteroposterior diameter of prostate whole gland and inner gland were measured, as well as artery resistance indexes of inner gland. 3D-TRUS was used to measure the volume and weight of prostate whole gland, the inner gland. The ratio of the width of the inside and outside the gland, the ratio of the thickness of the inside and outside the gland, and transition zone index （TZI） were calculated. Results Accord- ing to the weight of prostate whole gland, prostatic hyperplasia was classified into four levels： Ⅰ、Ⅱ、Ⅲand Ⅳ BPH. The weight of inner gland, TZI, RI of the inner gland artery, the ratio of inner and outer gland width and the ratio of in- ner and outer gland thickness in each group were IV〉Ⅳ〉Ⅲ〉Ⅱ〉Ⅰ （P〈0.01）, and were positively correlated with the weight of prostate （P〈0.01）. It is a better indicator of the grading of BPH. Conclusion Changes in the morphology and volume of prostate an provide important basis for the ultrasound diagnosis of prostatic hyperplasia. 3D-TRUS can accurately measure the volume of prostate whole gland and the inner gland, and provide the morphological index of the most intuitive for BPH grading. The measurement of prostate parameters is helpful in diagnosing the grading of BPH.