经直肠超声造影对前列腺实性结节的鉴别诊断价值

Value of contrast-enhanced transrectal ultrasound in differential diagnosis of prostate solid nodules

目的探讨经直肠超声造影特征在前列腺实性结节良恶性鉴别诊断中的应用价值。方法选取我院经穿刺活检病理证实的43例前列腺疾病患者,共55个实性结节,其中良性22个,恶性33个;比较良恶性结节经直肠超声造影血流灌注特征,包括增强时间、增强程度、消退时间、增强均匀度及增强后结节边界5个方面的差异。结果恶性结节主要表现为快进(25/33)、快出(20/33)、不均匀增强(21/33)、增强后边界清晰(21/33);良性结节主要表现为同进或慢进(13/22)、慢出(15/22)、均匀增强(17/22)、增强后边界不清晰(14/22),二者在增强时间、消退时间、增强均匀度及增强后结节边界比较差异均有统计学意义(均P<0.05);在增强程度方面比较差异无统计学意义。结论经直肠超声造影能够实时动态地观察前列腺良恶性实性结节的血流灌注情况,分析其超声造影特征,有助于提高对前列腺实性结节良、恶性鉴别诊断的能力。

Objective To investigate the application value of contrast-enhanced transrectal ultrasonound(CETRUS)in differential diagnosis benign and malignant prostate solid nodules.Methods A total of55solid nodules of43patients with prostate diseases confirmed by puncture pathology were selected,there were22benign nodules and33malignant nodules.The perfusion characteristics of CETRUS were analyzed,including enhanced time,the degree of enhancement,regression time,enhanced homogeneity and the enhanced boundary.The differences of perfusion characteristics between benign and malignant nodules were compared.Results Malignant nodules mainly manifested as fast in(25/33),fast out(20/33),heterogeneous enhancement(21/33)and well-defined boundary in the enhancement(21/33).Benign nodules mainly manifested as synchronous in or slow in and out(13/22,15/22),homogeneous enhancement(17/22)and unclear boundary in the enhancement(14/22).There were statistical significances of enhanced time,regression time,enhanced homogeneity and the enhanced boundary between benign and malignant nodules(all P<0.05).There was no significance in enhancement degree between the two groups.Conclusion CETRUS can observe real-time dynamic perfusion of prostate nodules,analysis of the characteristics of enhancement patterns can help to improve the ability of ultrasonography in differential diagnosis of prostate solid nodules.