经直肠超声弹性成像和超声造影在前列腺癌诊断中的应用价值

The clinical value of transrectal ultrasound elastography and the contrastenhanced ultrasonography in diagnosis of prostate cancer

目的探讨经直肠超声弹性成像(TRE)和超声造影在前列腺癌诊断中的应用价值。方法对95例疑诊为前列腺癌的患者行经直肠超声成像(TRUS)、TRE及超声造影检查。以超声引导下经直肠前列腺穿刺活检结果为金标准,分析TRUS、TRE及超声造影对前列腺癌的诊断价值。结果 95例患者共发现癌灶62个,TRUS检出29个,TRE检出41个,超声造影检出50个,其中TRE单独检出2个(3.23%),超声造影单独检出6个(9.68%)。TRUS诊断前列腺癌的敏感性、特异性、阴性预测值及阳性预测值分别为46.77%、58.18%、49.23%及55.77%,TRE的敏感性、特异性、阴性预测值及阳性预测值分别为66.13%、70.91%、65.00%及71.93%,超声造影的敏感性、特异性、阴性预测值及阳性预测值分别为80.64%、81.82%、78.95%及83.33%,超声造影联合TRE的敏感性、特异性、阴性预测值及阳性预测值分别为90.32%、85.45%、88.68%及87.50%。结论超声造影对前列腺癌的诊断价值较TRE更高,但对于超声造影无法明确诊断的病灶TRE有补充作用。

Objective To evaluate the clinical value of transrectal ultrasound elastography （TRE） and contrast enhanced ultrasound（ CEUS ）in diagnosis of prostate cancer.Methods Ninty-five patients with suspected prostate cancer were enrolled in this study.The transrectal ultrasound （TRUS）,TRE and CEUS were performed for all patients.The accuracy rate of prostate cancer detection using TRUS,TRE and CEUS were compared with the pathologic results.Results Altogether 62 prostate cancer lesions were diagnosed.Among these cases, 29 leions were detected by TRUS, 41 lesions were detected by TRE, 50 leions were detected by CEUS, 2 lesions （3.23%） were detected by TRE alone, 6 lesions （9.68%） were detected by CEUS alone.The sensitivity, specificity, positive predictive value, negative predictive value of TRUS,TRE, CEUS,TRE and CEUS in diagnosis of prostate cancer were 46.77%, 58.18%, 49.23%, 55.77%, 66.13%, 70.91%, 65.00%, 71.93%, 80.64%, 81.82%, 78.95% ,83.33% and 90.32%, 85.45% ,88.68% ,87.50% ,respectively.Conclusion CEUS is more valuable in differential diagnosis than TRE in orostate cancer, TRE is heloful to reach a correct diaznosis for orostate cancer when CEUS failed.