经直肠剪切波弹性成像技术对老年前列腺增生的诊断价值

Diagnosis and application of transrectal shear wave elastography in elderly prostate hyperplasia

目的研究经直肠剪切波弹性成像技术对老年前列腺增生的诊断效力。方法选择2018年1月至2019年12月因前列腺增生就诊的120例患者为研究对象,利用经直肠剪切波弹性成像技术,测量、记录感兴趣的弹性模量及穿刺活检结果,进行病理分型及判断SWEI诊断效力。结果病理结果显示,腺型占22.5%,间质型占25.8%,纤维腺型占17.5%,腺肌型占19.2%,混合型占15.0%。单因素方差分析发现方差齐,各组经直肠剪切波弹性成值结果不完全相同,通过两两比较发现,腺型<混合型<腺肌型<纤维腺型<间质型(P<0.05)。结果显示,腺体增生与间质增生弹性模量平均值分别为(24.19±4.78)kPa与(35.28±5.26)kPa,两值比较t=-22.086,P<0.05。前列腺增生患者ROC曲线面积为0.983,有着较高的准确率。采用经直肠剪切波弹性成像术对老年前列腺增生患者诊断的灵敏度为94.17%,特异度为93.33%,阳性预测值为91.11%,阴性预测值为96.00%,准确度为92.50%。结论经直肠剪切波弹性成像技术诊断老年前列腺增生的灵敏度、准确度均达到了90.00%以上,有着较好的诊断效力,值得临床深入研究及推广。

Objective To explore the diagnostic efficacy of transrectal shear wave elastography in elderly prostate hyperplasia.Methods A total of 120 patients with benign prostatic hyperplasia from January 2018 to December 2019 were selected as the research objects.Transrectal shear wave elastography was used to record and measure the elastic modulus of interest and the results of needle biopsy,and then perform pathology.Type and judge the effectiveness of SWEI diagnosis.Results The pathological results showed that the glandular type accounted for 22.5%,the interstitial type accounted for 25.8%,the fibroglandular type accounted for 17.5%,the adenomyosis type accounted for 19.2%,and the mixed type accounted for 15.0%.The univariate analysis of variance found that the variance was uniform.The results of shear wave elasticity are not completely the same.Through pairwise comparison,it is found that glandular type<mixed type<adenomus type<fibroadenous type<stromal type(P<0.05).The results show that glandular hyperplasia vs.stromal hyperplasia the average values of elastic modulus were(24.19±4.78)kPa vs(35.28±5.26)kPa,t=-22.086,P<0.05.the ROC curve area of patients with benign prostatic hyperplasia was 0.983,which has a high accuracy rate.The sensitivity of transrectal shear wave elastography in the diagnosis of elderly patients with prostate hyperplasia is 94.17%,specificity is 93.33%,positive predictive value is 91.11%,negative predictive value is 96.00%,and accuracy is 92.50%.Conclusion The sensitivity and accuracy of transrectal shear wave elastography for the diagnosis of elderly prostate hyperplasia have reached more than 90.00%,and it has a good diagnostic effect.It is worthy of in-depth clinical research and promotion.