经直肠实时组织弹性成像联合超声造影在诊断前列腺良恶性疾病中的应用价值

Applicable value of transrectal realtime tissue elastography combined with contrast-enhanced ultrasonography in discriminating between malignant and benign prostatic diseases

目的:探讨经直肠实时组织弹性成像(TRTE)联合超声造影(CEUS)在诊断前列腺良恶性疾病中的应用价值。方法:分析经病理证实的88例95个前列腺病灶的超声资料,计算TRTE、CEUS及两者联合诊断前列腺良恶性病变的敏感性、特异性、准确性、阳性预测值和阴性预测值,绘制TRTE、CEUS和两者联合应用的受试者工作特征(ROC)曲线,分别计算三者的曲线下面积(AUC),评估联合应用TRTE和CEUS诊断前列腺良恶性病变的价值。结果:TRTE诊断前列腺病变的敏感性为83.33%,特异性为78.72%,准确性为81.05%,阳性预测值80.00%,阴性预测值82.22%;CEUS诊断前列腺恶性病变对应的敏感性为87.5%,特异性为76.60%,准确性为82.11%,阳性预测值79.25%,阴性预测值85.71%;CEUS联合TRTE诊断前列腺恶性病变对应的敏感性为95.83%,特异性为80.85%,准确性为88.42%,阳性预测值83.63%,阴性预测值95.00%;TRTE的ROC曲线下面积为0.877,CEUS的ROC曲线下面积为0.820,TRTE联合CEUS的ROC曲线下面积为0.894,联合诊断的AUC略高于TRTE和CEUS的AUC,联合诊断的诊断价值稍高。TRTE和CEUS联合诊断的诊断准确性高于单独应用TRTE或CEUS,三者之间行χ2检验,差异有统计学意义(P<0.05)。结论:TRTE联合CEUS在诊断前列腺良恶性疾病中具有较高的价值,两者结合可提高疾病的诊断率。

Objective：To evaluate the applicable value of transrectal realtime tissue elastography（TRTE）combined with contrast-enhanced ultrasonography（CEUS）in discriminating between malignant and benign prostatic diseases.Method：The ultrasonic imaging features of 88 prostatic diseases patients with 95 lesions proved by pathology were reviewed.Differences of benign and malignant prostatic diseases in TRTE,CEUS and TRTE combined with CEUS were analyzed,and the sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value were calculated.Receiver operating characteristic（ROC）curves were made according to TRTE,CEUS and TRTE combined with CEUS,and area under the curve（AUC）was calculated to assess the accuracy of TRTE combined with CEUS.Result：The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of TRTE in discriminating between malignant and benign prostatic diseases were83.33%,78.72%,81.05%,80.00% and 82.22%,respectively.Those in CEUS were 87.50%,76.60%,82.11%,79.25%,and 85.71%,respectively.And those in TRTE combined with CEUS were 95.83%,80.85%,88.42%,83.63%and 95.00%,respectively.The AUC of TRTE combined with CEUS was superior to that of TRTE and CEUS separately.Conclusion：TRTE combined with CEUS has a high value in discriminating between malignant and benign prostatic diseases,and its diagnostic accuracy is superior to that of TRTE and CEUS separately.