超声二维血流参数及超声三维能量多普勒血流参数在诊断良性前列腺增生患者发生膀胱出口梗阻中的价值

Value of ultrasound two-dimensional blood flow parameters and ultrasound three-dimensional power Doppler blood flow parameters in the diagnosis of bladder outlet obstruction in patients with benign prostatic hyperplasia

目的探讨超声二维血流参数及超声三维能量多普勒血流参数在诊断良性前列腺增生(BPH)患者发生膀胱出口梗阻中的价值。方法选取77例良性前列腺增生(BPH)患者,根据尿流动力学检查中的梗阻指数(AG值)分为梗阻组47例(AG值≥40)与非梗阻组30例(AG值<40)。所有患者行经直肠前列腺超声二维检查、超声三维能量多普勒检查和尿流动力学检查。比较两组患者内腺动脉血流阻力指数、血流指数、血管形成指数(VI)、血管形成-血流指数(VFI)、AG值和最大尿流率。分析BPH患者的内腺动脉血流阻力指数、血流指数、VI、VFI与AG值、最大尿流率的相关性。绘制受试者工作特征(ROC)曲线分析内腺动脉血流阻力指数、血流指数、VI、VFI对BPH患者发生膀胱出口梗阻的诊断价值。结果梗阻组的内腺动脉血流阻力指数、血流指数、AG值高于非梗阻组,最大尿流率低于非梗阻组(均P<0.05),而两组的VI、VFI差异均无统计学意义(均P>0.05)。BPH患者的内腺动脉血流阻力指数与AG值呈正相关(P<0.05),而血流指数、VI、VFI与AG值,以及内腺动脉血流阻力指数、血流指数、VI、VFI与最大尿流率均无相关性(均P>0.05)。ROC曲线显示,内腺动脉血流阻力指数和血流指数诊断BPH患者发生膀胱出口梗阻的曲线下面积分别为0.849和0.656,而VI和VFI的诊断价值较低(曲线下面积均<0.6)。结论超声二维血流参数及超声三维能量多普勒血流参数对BPH患者发生膀胱出口梗阻均有一定的诊断价值,且内腺动脉血流阻力指数优于血流指数。

Objective To explore the value of ultrasound two-dimensional blood flow parameters and ultrasound three-dimensional power Doppler blood flow parameters in the diagnosis of bladder outlet obstruction in patients with benign prostatic hyperplasia(BPH).Methods A total of 77 BPH patients were selected.According to the obstruction index(AG value)in the examination of urodynamics,the patients were assigned to obstruction group(47 cases,AG value≥40)or non-obstruction group(30 cases,AG value<40).All patients underwent transrectal prostatic ultrasound two-dimensional examination,ultrasound three-dimensional power Doppler examination and urodynamics examination.Resistance index of prostate intraglandular arterial blood flow,blood flow index,vascularization index(VI),vascularization flow index(VFI),AG value and the maximum urine flow rate were compared between the two groups.The correlation of resistance index of prostate intraglandular arterial blood flow,blood flow index,VI,VFI with AG value and the maximum urine flow rate in BPH patients was analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of resistance index of prostate intraglandular arterial blood flow,blood flow index,VI and VFI on BPH patients suffering from bladder outlet obstruction.Results The obstruction group yielded higher resistance index of prostate intraglandular arterial blood flow,blood flow index and AG value,as well as lower maximum urine flow rate compared to the non-obstruction group(all P<0.05),whereas there was no statistically significant difference in VI and VFI between the two groups(all P>0.05).Resistance index of prostate intraglandular arterial blood flow positively correlated with AG value in BPH patients(P<0.05),while blood flow index,VI,and VFI had no correlation with AG value,as well as resistance index of prostate intraglandular arterial blood flow,blood flow index,VI and VFI interpreted no correlation with the maximum urine flow rate(all P>0.05).ROC curve interpreted that the areas under the curve of resistance index of prostate intraglandular arterial blood flow,and blood flow index for diagnosing BPH patients suffering from bladder outlet obstruction were 0.849 and 0.656,respectively,whereas VI and VFI exhibited a relatively low diagnostic value(the areas under the curve all<0.6).Conclusion Ultrasound two-dimensional blood flow parameters and ultrasound three-dimensional power Doppler blood flow parameters exert a diagnostic value on BPH patients suffering from bladder outlet obstruction to a certain extent,and resistance index of prostate intraglandular arterial blood flow is superior to blood flow index.