腺体增生和间质增生为主的前列腺增生疾病的优选诊断方式

The Optimal Diagnosis of Benign Prostatic Hyperplasia with GlandularHyperplasia and Interstitial Hyperplasia

目的探索剪切波定量超声弹性成像技术(SWEI)诊断前列腺增生(BPH)病理类型的价值。方法分析132例BPH确诊病例的SWEI结果,比较BPH 5个病理类型(腺型、混合型、间质型、腺肌型、纤维腺型)间弹性模量值水平的差异,并将BPH病理类型2分类分为腺体增生组(腺型、混合型)和间质增生组(间质型、腺肌型、纤维腺型),绘制受试者工作曲线(ROC)并确定约登指数、最佳截断点等。结果(1)BPH 5个病理类型的弹性模量值两两比较差异均有统计学意义(P<0.05),且由低到高依次为:腺型<混合型<腺肌型<纤维腺型<间质型;(2)腺体增生组和间质增生组弹性模量值比较差异有统计学意义(P<0.05);(3)ROC曲线下面积(AUC)为0.916,Youden指数最大值为0.879,最佳截断点为28.16kPa,SWEI区分BPH属腺体增生为主的灵敏度94.12%,特异性93.83%,阳性预测值90.57%,阴性预测值96.20%,准确度93.94%。结论不同BPH病理类型间SWEI弹性模量存在差异;SWEI判断BHP属腺体增生/间质增生为主中有较高的诊断效能。

Objective To explore the value of shear wave elasticity imaging(SWEI)in the diagnosis of benign prostatic hyperplasia(BPH).Methods SWEI results of 132 BPH-confirmed cases were analyzed.The differences of elasticity modulus between 5 pathological types of BPH(gland type,mixed type,interstitial type,adenoid type,fibrous gland type)were compared,and 2 classifications of BPH pathological types were classified into the glandular hyperplasia group(including gland type,mixed type)and interstitial hyperplasia group(including interstitial type,interstitial type).The subjects’work curve(ROC)was drawn and Jorden index and the best truncation point were determined.Results(1)The differences of elasticity modulus among 5 pathological types of BPH were statistically significant(P<0.05),From low to high level,they were classified as:glandular type<mixed type<interstitial type<glandular muscle type<fibrous gland type.(2)There was a significant difference in elastic modulus between the glandular hyperplasia group and interstitial hyperplasia group(P<0.05);(3)AUC value was 0.916,and the maximum value of Youden index was 0.879,while the best truncation point was 28.16kPa.SWEI distinguished BPH from glandular hyperplasia with sensitivity of 94.12%and specificity of 93.83%,positive predictive value of 90.57%,negative predictive value of 96.20%,and accuracy of 93.94%.Conclusion There are differences in SWEI elastic modulus among different BPH pathological types;SWEI has a higher diagnostic potency for BHP gland hyperplasia.