经直肠彩色多普勒超声鉴别前列腺周缘区低回声性质的价值

Evaluation of peripheral hypoechoic lesions of prostate with transrectal color Doppler ultrasonography

目的 探讨经直肠彩色多普勒超声对前列腺周缘区低回声结节良恶性诊断的价值。方法 对 77例前列腺周缘区低回声结节行经直肠彩色多普勒超声探测 ,利用彩色直方图软件计算结节内彩色血流面积与选定结节面积比值 (blackandwhitecolorratio ,BCR)和整个前列腺血流BCR并比较二者的BCR ,如结节内BCR高于整个前列腺内 5 %则为血流增多。结果 77例前列腺周缘区低回声结节穿刺活检证实前列腺癌 5 1例 ,前列腺增生症 2 6例。周缘区低回声内血流增多共 5 0例 ,其中前列腺癌 41例。经直肠彩色多普勒超声检查结节内血流增加对诊断前列腺癌的敏感性、特异性、阳性预测值分别为 80 .4% ,65 .4% ,82 .0 %。结论 经直肠彩色多普勒超声检查前列腺周缘区低回声结节内血流并用BCR解释其丰富程度对结节良恶性的鉴别诊断有一定帮助。

Objective To study role of color Doppler ultrasonography in predicting the benignity and malignancy of the peripheral hypoechoic lesion of the prostate.Methods Seventy-seven patients who had peripheral hypoechoic lesions were detected with transrectal color Doppler ultrasonography.The black and white color ratio (BCR) in peripheral hypoechoic was calculated by color histogram and compared with prostate BCR.The amount of flow signal was considered increasing if BCR in the lesions was higher than 5% in their prostate.Results Transrectal ultrasound-guilded biopsy of the hypoechoic lesions revealed prostate cancer in 51 patients and benign prostate hypertrophy in 26 patients.The increase of flow signal was in 50 patients,41 of them were prostate cancer.For an increased flow signal within a peripheral hypoechoic lesion as a signal of prostate cancer,color Doppler ultrasonography has a sensitivity of 80.4% ,a specificity of 65.4% ,and a positive predictive value of 82.0% .Conclusions Color Doppler ultrasonography through rectum on blood flow in peri-prostate hypoechoic nodules with BCR account for their rich degree in malignancy and benignity differentiation.