经直肠彩色多普勒能量图对前列腺癌的诊断价值

The value of transrectal color Doppler energy in the diagnosis of prostate cancer

目的 探讨经直肠彩色多普勒能量图 (CDE)对前列腺癌的诊断价值。方法 对经病理证实的 2 4例前列腺癌 (34个结节 )和 30例前列腺良性病变患者采用经直肠CDE检查 ,10例为正常对照组。将前列腺腺体及结节CDE血流图分别进行 0～ 3级分级评定 ,并与彩色多普勒血流显像 (CDFI)比较。结果 ①前列腺癌血流图分级以 2、3级为主 ,占 88.2 % ,前列腺良性病变则以 0、1级为主 ,占 80 .0 % ;②CDE诊断前列腺癌的敏感性为88.2 % ,特异性为 80 .0 % ,阳性预期值为 79.0 % ,阴性预期值为 88.9% ;③CDE在前列腺癌的血流显示方面优于CDFI ,但二者在血流分级及判断前列腺良恶性病变方面无显著差别 (P >0 .0 5 )。结论 经直肠CDE检查对前列腺癌的诊断具有重要价值 ,当CDE显示前列腺结节周边和 (或 )内部有异常增多的血流 ,尤其当结节位于周围带时 ,应高度怀疑前列腺癌的可能。

Objective To evaluate the value of transrectal color Doppler energy (CDE) in the diagnosis of prostate cancer.Methods Pathologic results of 24 cases with prostate cancer(34 nodes) and 30 cases with prostate benign disease were studied by transrectal CDE,10 normal subjects were as contrasl group. The vascularity on CDE of prostates and prostatic nodes was graded respectively on a scale of 0～3 and compared with color Doppler flow imaging (CDFI).Results ① According to the grades of the vascularity on CDE: 88.24% prostate cancer belonged to 2 and 3 grade,whereas 80.0% prostate benign diseases 0 and 1 grade. ②The sensitivity of CDE in diagnosing prostate cancer was 88.2% ,the specificity 80.0% ,the positive predictive value 79.0% ,the negative predictive value 88.9% ;③ In prostate cancer,the blood flow display of CDE was more favorable than that of CDFI,but there was little difference between them in blood flow grading and differential diagnosis of benign and malignant prostate diseases (P> 0.05 ).Conclusions Transrectal CDE plays important role in diagnosing prostate cancer,the prostate cancer should be highly suspected in case with focal abnormal hypervascularity on CDE within and/or around prostate node,especially in peripheral zone.