超声造影定量分析评价前列腺良恶性组织血流灌注特征的初步研究  

Quantitative Analysis in Assessing Perfusion Characteristics of Malignant and Benign Tissues of Prostate with Contrast-enhanced Ultrasonography: A Prospective Study

作　　者：谢少伟[1] 李凤华[1] 夏建国[1] 杜晶[1] 方华[1] 王燕[1] 陈哲[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,上海市200001

出　　处：《中国超声医学杂志》2010年第9期826-829,共4页Chinese Journal of Ultrasound in Medicine

基　　金：上海市重点学科建设项目资助(No.S30203);海交通大学医学院附属仁济医院横向课题(No.2009 RJHX-07)

摘　　要：目的探讨超声造影定量分析在鉴别前列腺外腺良恶性组织中的应用价值。方法对52例行前列腺活检的患者行实时灰阶超声造影检查,对穿刺点处作时间强度曲线分析,获得以下参数:基础强度(BI)、峰值强度(PI)、增强强度(ASI)、到达时间(AT)、达峰时间(TTP)、曲线上升时间(ACT)、上升斜率(a3)、下降斜率(a2)、曲线下面积(AUC),对比分析前列腺良恶性组织的造影参数。结果 52例患者造影切面穿刺病理诊断为前列腺癌22例。52例患者前列腺癌区的BI、ASI与良性组织区相比,差异有统计学意义(P=0.036、P=0.017);对22例前列腺癌患者行自身配对检验,前列腺癌区的BI、ASI、AT、a3与良性组织区相比,差异有统计学意义(P=0.031、P=0.028、P=0.007、P=0.009);对30例良性前列腺病变患者行自身配对检验,双侧外腺的BI、PI差异有统计学意义(P=0.009、P=0.008)。结论超声造影定量分析对前列腺癌病灶具有显示快进、快速达峰、高增强的血流灌注特点,有利于良恶性组织的鉴别。并且,实时灰阶超声造影能客观地反映前列腺双侧外腺良性组织对称性的血流灌注特点。Objective To analyze and evaluate perfusion characteristics of malignant and benign tissues of prostate with contrast-enhanced ultrasonography （CEUS）and investigate the potential efficacy of real-time gray-scale CEUS in differentiating malignant lesions from benign tissues in prostate. Methods Fifty-two patients with serum prostate-specific antigen levels higher than 4.00ng/ml underwent CEUS and biopsy guided by sonographically. The regions of interest （ROIs）were drawn in the sites of biopsy, and the time-intensity curves were analyzed for the following indices ： baseline intensity （BI）, peak intensity （PI）, increased signal intensity （ASI） , arrival time （AT） , time to peak （TTP）, accelerate time （ACT）, wash-out slope of the curve （a2）, rise slope of the curve （a3）and area under the time intensity curve （AUC）. Results Prostate cancers were detected in 22 of 52 patients. Malignant lesions and benign tis- sues differred significantly in BI and △SI （P=0. 036 ,P=0. 017）. In the same patient of prostate cancer,the parameters of BI,ASI,AT and a3 in malignant lesions were significantly different from those in benign tissues （P= 0. 031, P=0. 028 ,P=0. 007 ,P=0. 009）and in the same patient with right and left benign outer gland tissues differred significantly in BI and PI （P=0. 009,P=0. 008）. Conclusions The quantitative analysis with real-time gray-scale CEUS indicts shows prostate cancer is with the blood perfusion characteristics of faster arrival,quicker wash-in and higher enhancement,and may help differentiate malignant lesions from benign tissues in prostate and it also reflects the symmetric blood perfusion characteristics in both sides of benign outer gland tissue objectively.

关 键 词：前列腺 超声造影 定量分析 

分 类 号：R445.1[医药卫生—影像医学与核医学]