超声造影在前列腺癌诊断及指导前列腺活检中的价值探讨

Value of contrast-enhanced ultrasound in diagnosis of prostate cancer and guiding prostate puncture biopsy

目的探讨经直肠前列腺超声造影在前列腺癌活检中的临床应用价值。方法选择73例血清前列腺特异性抗原(PSA)≥4 ng/mL,且直肠指检阳性或经直肠超声发现可疑病灶的患者行超声造影检查,随后行超声造影异常增强区靶向穿刺+6点常规穿刺,对超声造影未见异常者行常规6点穿刺。以病理结果为对照,分析超声造影图像特征。结果以病理为标准,超声造影诊断前列腺癌的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为73.33%、93.02%、84.93%、88.00%、83.33%。前列腺癌超声造影声像图特征主要有前列腺外腺局灶性异常增强,以及内外腺分界不清。结论超声造影诊断前列腺癌的阳性预测值较高,对引导穿刺活检有一定的指导意义。

Objective To explore the clinical application value of contrast-enhanced ultrasound （CEUS） in the diagnosis of prostate cancer and guiding prostate puncture biopsy. Methods A total of 73 patients with serum prostate specific antigen （PSA）≥4 ng/mL and abnormal findings of digital rectal examination or suspected lesions examined with transrectal ultrasonography （TRUS） underwent CEUS. Then transracial ultrasound-guided prostate biopsy （TRUPB） was performed at the suspicious region and conventional puncture was performed at＋6 o’clock position simultaneously. The patients with no abnormal CEUS findings received conventional puncture at 6 o’clock position. The CEUS features were analyzed and compared with the pathological results. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CEUS was 73.33%, 93.02%, 84.93%, 88.00% and 83.33%, respectively. The CEUS features of prostate cancer mainly included focal abnormal contrast enhancement and no clear boundary between inner and outer glands. Conclusion CEUS has a high positive predictive value in the diagnosis of prostate cancer, and is of significance in guiding prostate puncture biopsy.