剪切波弹性成像技术在前列腺增生药物治疗效果评价中的应用

Application of shear wave elastography in evaluation of therapeutic effect of drugs for prostatic hyperplasia

目的探讨前列腺增生患者药物治疗前后前列腺组织移行区、周围区弹性模量的变化。方法选取2015年7月至2017年1月确诊为前列腺增生并口服药物治疗的患者175例,采用经直肠实时剪切波弹性超声成像技术测量前列腺组织移行区和周围区弹性模量。比较患者治疗前后前列腺增生程度变化,分析药物治疗前后患者前列腺组织移行区和周围区弹性模量的影响,分析前列腺组织移行区、周围区弹性模量与患者国际前列腺症状评分(IPSS)、生活质量评分(QOL)评分、最大尿流率、前列腺体积、剩余尿量的相关性。结果药物治疗后患者前列腺组织移行区和周围区弹性模量分别由(59.20±6.03)、(25.04±2.89)kPa,降至(39.66±6.03)、(14.46±3.01)kPa,2组变化差异均有统计学意义(P<0.05)。前列腺组织移行区弹性模量与IPSS评分、QOL评分、Qmax、PV、PVR具有较明显的相关性(r值分别为0.74、0.82、-0.75、0.51、0.77,P均<0.05),而前列腺组织周围区弹性模量与IPSS评分、QOL评分、Qmax、PV、剩余尿量(PVR)相关性较弱(r值分别为0.57、0.73、-0.62、0.42、0.53,P均<0.05)。结论实时剪切波弹性超声成像技术能够提供前列腺增生患者药物治疗前后的前列腺组织硬度信息、评估药物治疗前列腺增生的治疗效果。

Objective To investigate the changes of elastic modulus in the transitional and peripheral regions of prostate tissue before and after drug treatment in patients with benign prostatic hyperplasia(BPH).Methods A total of 175 patients with BPH who were diagnosed and treated in our hospital from July 2015 to January 2017 were enrolled in the study.Transrectal real-time shear wave elastography was used to measure the elastic modulus of the transitional and peripheral regions of prostate tissue.The changes in the degree of prostate hyperplasia before and after treatment were compared,and the therapeutic effect on the elastic modulus of the transitional and peripheral regions of prostate tissue before and after treatment were analyzed.In addition,the correlation of the elastic modulus of the transitional and peripheral regions of prostate tissue with IPSS,QOL score,maximum urine flow rate,prostate volume and residual urine volume was analyzed.Results After the drug treatment,the elastic modulus of the transitional and peripheral regions of the prostate tissue was decreased from(59.20±6.03)and(25.04±2.89)kPa to(39.66±6.03)and(14.46±3.01)kPa,respectively,and there were significant differences between the two groups(P<0.05).The elastic modulus of transitional region of the prostate tissue was significantly correlated with the IPSS score,QOL score,Qmax,PV,and PVR(r values were 0.74,0.82,-0.75,0.51,and 0.77,respectively,all P<0.05),and the elastic modulus of peripheral regions of the prostate tissue was weakly correlated with the IPSS score,QOL score,Qmax,PV,and PVR(r values were 0.57,0.73,-0.62,0.42,and 0.53,respectively,all P<0.05).Conclusion Real-time shear wave elastography can provide information on the hardness of prostate tissue before and after drug treatment for patients with BPH,thereby evaluating the effect of drug treatment for BPH.