超声造影诊断前列腺良恶性病变的价值  

The value of contrast enhanced ultrasound in diagnosis of benign and malignant prostatic neoplasms

作　　者：查月琴[1] 沈卫东[1] 林和平[1] 蔡宗强[2] 陈卫国[2] 沈玲玲[1] 蔡晓峰[1] 侯建全[2] 

机构地区：[1]苏州大学附属第一医院超声科,215006 [2]苏州大学附属第一医院泌尿外科,215006

出　　处：《中华超声影像学杂志》2010年第1期32-35,共4页Chinese Journal of Ultrasonography

基　　金：苏州市科技局资助项目（SSY0621）

摘　　要：目的探讨经直肠超声造影在诊断前列腺良恶性病变中的价值。方法对60例血清前列腺特异性抗原增高并疑有前列腺疾病患者行经直肠超声检查，采用SonoVue造影剂结合CPS造影成像技术行超声造影，并观察造影增强方式及增强强度，造影结束同时对患者行经直肠超声引导穿刺活检。对其中38例良、恶性结节患者用ACQ软件绘制时间-强度曲线（TIC），分析造影参数，比较良、恶性间的差异。结果60例前列腺疾病患者均得到病理证实。良性病变37例，其中结节性病变15例共20个结节，前列腺增生22例。恶性病变23例，结节病灶18例18个，弥漫性病变5例。内腺良性结节超声造影增强方式以均匀增强为主，结节边界清晰；恶性结节以早于正常外腺组织增强为主。恶性结节达峰时间及加速时问均短于良性结节（P〈0．05），峰值强度低于良性结节（P〈0．05），到达时间良、恶性间差异无统计学意义（P〉0．05）。超声造影对前列腺病变的良恶性鉴别诊断符合率要高于常规经直肠超声（P〈0．05）。超声造影诊断的敏感度、特异度和正确率均高于常规经直肠超声，而误诊率、漏诊率均小于常规经直肠超声。结论经直肠超声造影对前列腺癌的早期发现及对良恶性病变的鉴别诊断均具有一定的临床应用价值。Objective To evaluate the value of transrectal contrast enhanced ultrasound （TR-CEUS） in diagnosis of benign and malignant prostatic neoplasms. Methods Sixty patients with elevated level of serum prostate specific antigen and suspected prostate diseases were examined with transrectal ultrasound（TRUS）, and TR-CEUS. The pattern and intensity of CEUS in these patients were observed;and the patients with nodules were examined with CEUS guided biopsy and sextant system biopsy after ultrasound imaging. Time-intensity curves （TIC） were drawn to calculate the parameters, and the difference between benign and malignant nodes was compared. Results All sixty prostate patients were confirmed by pathological examination. Thirty-seven patients belong to benign lesions, among them 15 patients with nodule lesion had total 20 nodules, while 22 cases had benign prostatic hyperplasia. In 23 cases of malignant lesions, 18 cases had centralized nodules and 5 cases showed diffuse pathologic changes. Benign nodes of inner gland showed a main pattern of homogenous enhancement and a clear node zone, whereas, malignant nodes displayed significant enhancement in peripheral tissue. The time to peak and accelerating time （ACT） of malignant nodes were shorter than those of benign nodes （ P 〈0.05）. There was no significance in arrival time （AT） between the two groups （ P 〉0.05）. The accordance rate of TR-CEUS in the differential diagnosis of benign and malignant prostatic lesions was higher than that of TRUS （ P 〈0.05）. In addition, the sensitivity, specificity and accurate rate of TR-CEUS were higher than those of TRUS, whereas, both misdiagnosis and missed diagnosis rate of TR-CEUS were lower than those of TRUS. Conclusions TR-CEUS has clinical value for early discovery of prostatic cancer and has higher application value to differentiate malignant from benign diseases.

关 键 词：腔内超声检查 微气泡 前列腺肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学]