前列腺癌经直肠超声的临床分期声像特征与优势分析

Analysis of Ultrasonographic Characteristics of Clinical Staging and Advantages by Transrectal Ultrasound in Prostate Cancer

目的：分析经直肠超声在检查前列腺癌中临床分期的超声声像特征与优点,反映其临床应用价值。方法：采用GE logie 500Pro彩色多普勒超声诊断仪,探头频率5～7.5 MHz进行检测,对55例年龄58～89岁（平均73.5岁）、直肠指检（DRE）触及前列腺质地较硬或可疑结节、血清特异性抗原（PSA）〉4 ng/m L的患者进行直肠超声（TRUS）检查,结合临床分期对比超声声像图表现及特征,同时这些病例均进行直肠超声引导穿刺活检,并手术证实为前列腺癌。结果：55例患者中,直肠超声检出前列腺癌48例,符合率可达87.3%,超声表现特征呈形态不规整,边界欠光滑,内外腺分界不清,局部隆起,低回声结节或突破包膜、侵犯邻近组织或远处转移;7例诊断为前列腺增生或增生结节,误诊率为12.7%,超声表现特征呈形态尚整齐,边界光滑,内外腺分界清晰,内部中等回声而周边一细狭的低回声结节。结论：经直肠超声是前列腺癌阳性检出率较高的筛查方法,根据声像图特征初步判定临床分期,具有临床价值。其图像分辨率明显优于经腹部检查,且无创伤、费用低、操作简单、患者容易接受,对临床有着重要的应用价值。

Objective：To analyze the ultrasonographic characteristics of clinical staging and advantages by transrectal ultrasound in the examination of prostate cancer,and to reflect its clinical application value.Method：55 patients were detected by GE Logie 500 Pro color Doppler ultrasonic diagnostic apparatus,probe frequency 5-7.5 MHz,they were aged 58-89 years old,average 73.5 years old,digital rectal examination（DRE） touch prostate hard or suspicious nodules,serum specific antigen（PSA）4 ng/m L and detected by transrectal ultrasound（TRUS）,combined with clinical staging contrasted ultrasonographic manifestations and characteristics,and these patients were performed transrectal ultrasound guided biopsy,and surgery confirmed for prostate cancer.Result：In 55 cases,48 cases of prostate cancer were detected by rectal ultrasound,the coincidence rate was 87.3%,the ultrasound characteristics were not regular,the boundary less smooth,internal and external gland boundary was not clear,local uplift,hypoechoic nodules or breakthrough coating,invasion of adjacent tissue or distant metastasis.7 cases were diagnosed as benign prostatic hyperplasia or nodular hyperplasia,the misdiagnosis rate was 12.7%,the sonographic features were neat shape,smooth boundary,internal and external gland boundary was clear,internal medium echo and the surrounding medium had a narrow low echo tubercle.Conclusion：Transrectal ultrasound is a higher positive detection rate of prostate cancer screening method,according to the sonographic characteristics determine the initial clinical stage,has clinical value.The image resolution is significantly better than the examination of the abdomen,and non-invasive,low cost,simple operation,easy to be accepted by patients,has important application value for clinical.