前列腺癌超声微钙化特征及超声造影参数与骨转移的相关性

Correlations of ultrasound microcalcification of prostate cancer and contrast-enhanced ultrasound parameters with bone metastasis

目的探讨前列腺癌患者超声微钙化特征及超声造影参数与骨转移的相关性。方法前列腺癌患者106例,均行经直肠超声、超声造影、超声引导下前列腺穿刺活检及骨扫描检查。将106例患者依据二维超声声像前列腺内钙化灶数量及直径分为无钙化组23例,微钙化组24例,其他钙化组59例。依据骨扫描检查结果判定3组骨转移情况,依据组织活检病理结果进行分级。比较3组骨转移比率、病理分级及超声造影参数间差异。结果 106例中44例发生骨转移,62例无骨转移。微钙化组骨转移比率(75.0%)高于无钙化组(34.8%)和其他钙化组(30.5%)(P<0.05),其他钙化组与无钙化组比较差异无统计学意义(P>0.05)。微钙化组病理分级4+5级比率(83.3%)高于无钙化组(21.7%)(P<0.05),与其他钙化组(50.8%)比较差异无统计学意义(P>0.05),其他钙化组与无钙化组比较差异无统计学意义(P>0.05)。微钙化组、其他钙化组造影参数中峰值强度[10.45(8.28,13.43)、9.51(7.71,11.64)dB]、曲线下面积[758.47(598.95,971.93)、623.3(496.49,855.65)dBs]大于无钙化组[4.43(3.47,6.46) dB、196.53(108.45,358.39)dBs],上升时间[4.72(3.89,6.29)、6.69(5.27,9.26)s]低于无钙化组[7.52(5.57,11.18)s](P<0.05);微钙化组平均渡越时间[27.10(25.16,30.71)s]低于无钙化组[34.56(29.28,50.09)s](P<0.05);其他钙化组上升支斜率[1.42(0.64,1.91) dB/s]大于无钙化组[1.16(0.66,2.23) dB/s](P<0.05)。结论前列腺癌超声微钙化特征及超声造影参数与骨转移有一定相关性,于微钙化周围增加穿刺针数靶向组织活检可辅助骨转移的诊断。

Objective To investigate the correlations of ultrasonographic microcalcification and contrast-enhanced ultrasound(CEUS) parameters with bone metastasis in prostate cancer. Methods Totally 106 patients with prostate cancer underwent transrectal ultrasound, CEUS and ultrasound-guided prostate biopsy and bone scan. According to the number and diameter of calcification lesions in the prostate under two-dimensional ultrasound, 106 patients were divided into non-calcification group(n=23), microcalcification group(n=24) and other calcification group(n=59). Patients in three groups were detected bone metastasis by bone scan, and were graded on the basis of biopsy pathologic results. Bone metastasis rate, pathological grade and CEUS differences were compared among three groups. Results In 106 patients, 44 had bone metastasis and 62 had no bone metastasis. The metastasis rate was higher in microcalcification group(75.0%) than that in non-calcification group(34.8%) and other calcification group(30.5%)(P<0.05), and showed no significant difference between non-calcification group and other calcification group(P>0.05). The percentage of pathological grade 4+5 was higher in microcalcification group(83.3%) than that in non-calcification group(21.7%)(P<0.05), and showed no significant difference between microcalcification group and other calcification group(50.8%)(P>0.05) as well as between other calcification group and non-calcification group(P>0.05). The peak intensity and area under the curve were higher in microcacification group(10.45(8.28, 13.43) dB, 758.47(598.95, 971.93) dBs) and other calcification group(9.51(7.71, 11.64) dB, 623.3(496.49, 855.65) dBs) than those in non-calcification group(4.43(3.47, 6.46) dB, 196.53(108.45, 358.39) dBs)(P<0.05), and the raise time was shorter in microcalcification group(4.72(3.89, 6.29) s) and other calcification group(6.69(5.27, 9.26) s) than that in non-calcification group(7.52(5.57,11.18)s)(P<0.05).The mean transit time was shorter in mocricalcification group(27.10(25.16,30.71)s)than that in non-calcification group(34.56(29.28,50.09)s)(P<0.05).The wash in slop was larger in other calcification group(1.42(0.64,1.91)dB/s)than that in non-calcification group(1.16(0.66,2.23)dB/s)(P<0.05).Conclusion Ultrasonographic microcalcification features of prostate cancer and CEUS are correlated with bone metastasis,and increasing the number of puncture needle targeted biopsies around microcalcification contributes to the diagnosis of bone metastasis.