经直肠超声造影指导前列腺穿刺活检的临床价值

Value of contrast-enhanced transrectal ultrasound in prostatic biopsy

目的对比超声造影与常规超声引导穿刺活检结果,探讨经直肠超声造影对引导前列腺穿刺活检的优势。方法 195例可疑前列腺癌患者行前列腺穿刺活检,随机分为造影组60例,经直肠超声造影指导前列腺穿刺;对照组135例,经直肠超声引导前列腺穿刺。对比两组前列腺癌检出率、穿刺针数及单针阳性率。结果造影组60例患者,恶性42例,良性18例,前列腺癌诊断率为70.0%,共接受穿刺716针,平均12针;阳性针数352针,阳性率为49.2%。对照组135例患者,恶性95例,良性40例,前列腺癌诊断率为70.4%,共接受穿刺1431针,平均11针,阳性针数466针,阳性率为32.6%;两组前列腺癌诊断率和平均穿刺针数,差异无统计学意义(P>0.05),造影组针数阳性率高于对照组(P<0.01)。结论应用超声造影引导对前列腺可疑部位进行经直肠穿刺活检,能明显提高诊断前列腺癌的敏感性和穿刺的单针诊断率。

Objective To evaluate the value of contrast-enhanced transrectal ultrasound （CETRUS） for prostate cancer （PCa） detection compared to conventional transrectal ultrasound （TRUS）. Methods A total of 196 patients of with suspicious PCa were performed transrectal ultrasound guided prostate biopsy and randomly divided into contrast group （60 cases） and non-contrast group （135）. The detection rate, features of contrast pattern, number of puncture needle and positive rate of single needle were compared between the two groups. Results Among 60 cases in the contrast examination group, 42 cases were malignant and 18 cases were benign. The diagnosis rate of PCa was 70.0%. Totally 716 needles of puncture were performed in 60 cases and the average number of needling was 12. The number of positively needling was 352 and positive rate was 49.2%. In the non-contrast group, 95 of 135 cases were malignant and 40 cases were benign. The diagnosis rate of PCa was 70.4%. A total of 1431 needles of puncture were performed in 135 cases and the average number of needling was 10.6. The number of positively needling were 466 and positive rate was 32.6%.There was no statistical difference in the diagnosis rate and average needles of puncture between the two groups（P〉0.05）. The positive rate of needling was higher in contrast group compared with that in non-contrast groups（P〈0.01）. Conclusion CETRUS could guide the puncture for PCa detection of suspicious nodules, improving the sensibility of PCa detection and especially increase the diagnosis rate of single needling.