不同血清前列腺特异抗原水平前列腺癌超声造影微血管成像与常规超声靶向引导穿刺活检的对比  

Contrast-enhanced ultrasonographic microflow imaging and traditional transrectal ultrasound-guided prostate cancer detection in different serum prostate-specific antigen levels

作　　者：郭祎芬[1] 李凤华[1] 谢少伟[1] 夏建国[1] 杜晶[1] 王燕[1] 

机构地区：[1]上海交通大学医学院附属仁济医院超声医学科,上海200001

出　　处：《中国医学影像技术》2010年第7期1304-1307,共4页Chinese Journal of Medical Imaging Technology

基　　金：上海市重点学科建设项目(S30203);上海高校选拔培养优秀青年教师科研专项基金(JDY09006);上海交通大学医学院附属仁济医院横向课题项目(2009RJHX-07)

摘　　要：目的比较不同血清前列腺特异抗原(PSA)水平下超声造影微血管成像(MFI)与常规超声靶向引导前列腺癌穿刺活检的价值。方法对65例血清PSA升高(≥4ng/ml)的患者行经直肠前列腺穿刺活检,分为A(4ng/ml≤PSA<10ng/ml)、B(10ng/ml≤PSA<20ng/ml)、C(PSA≥20ng/ml)三组,活检前行经直肠灰阶、彩色多普勒能量图(CDE)及MFI检查。在超声引导下对每例患者行底、中、尖三切面12点穿刺。以病理结果为金标准,比较不同PSA水平组中MFI与常规超声靶向引导前列腺癌穿刺活检的价值。结果 65例患者有230针穿刺活检病理诊断为前列腺癌。A组、B组中MFI检出恶性病灶的敏感度均高于灰阶及CDE(P<0.01),C组中MFI的敏感度、准确率及阴性预测值均高于灰阶及CDE(P<0.01)。三组间MFI靶向引导前列腺活检的敏感度和准确率差异无统计学意义(P>0.05)。结论对不同PSA水平前列腺癌,MFI均较常规超声靶向引导穿刺活检的敏感性高。Objective To compare the value of contrast-enhanced ultrasonographic micro flow imaging （MFI） and traditional transrectal ultrasound-guided prostate cancer detection in different serum prostate-specific antigen （PSA） levels. Methods Totolly 65 patients with PSA higher than 4 ng/ml were evaluated with transrectal grey scale,color Doppler energy （CDE） and MFI examinations before biopsy. All patients were divided into three groups according to the PSA levels：Group A：4—10 ng/ml; B：10—20 ng/ml; and C：≥20 ng/ml. Biopsy was performed at 12 sites in the base,the mid gland and the apex in each patient. Taking pathology results as reference standards,the diagnostic values were assessed in three different groups with defferent methods. Results Totally 230 specimens were malignant in 65 patients. The sensitivity of MFI in group A and B was higher than that of grey scale and CDE （P〈0.01）. In group C,the sensitivity,accuracy and negative predictive value of MFI were higher than those of grey scale and CDE （P〈0.01）. The difference of sensitivity and accurary among three groups was not significant （P〉0.05）. Conclusion MFI can improve the sensitivity of the prostate cancer detection in different serum prostate-specific antigen levels.

关 键 词：前列腺肿瘤 超声检查 介入性 微血管成像 穿刺 前列腺特异抗原 

分 类 号：R737.25[医药卫生—肿瘤] R445.1[医药卫生—临床医学]