前列腺癌经直肠超声表现及特征与临床分期探讨  

The Clinical Stages and Characteristic of Transrectal Ultrasonography for Diagnosing Prostate Carcinoma

作　　者：王小燕[1] 凌冰[1] 黄向红[1] 农美芬[1] 贺琰[1] 董小圆[1] 韦海明[2] 

机构地区：[1]广西壮族自治区人民医院超声科,南宁市530021 [2]广西壮族自治区人民医院病理科,南宁市530021

出　　处：《中国超声医学杂志》2014年第2期150-154,共5页Chinese Journal of Ultrasound in Medicine

基　　金：广西自然科学基金项目面上项目(No.2011GXNSFA018295)

摘　　要：目的系统地观察及探讨前列腺癌(PCa)的经直肠超声(TRUS)特征性表现。方法应用经直肠彩色多普勒超声对122例临床拟诊为PCa患者进行检查,测量其大小、面积,观察有无结节、血供丰富与否,测量其血流速度及阻力指数。然后经直肠超声引导下前列腺穿刺,采用方法为系统6点加可疑结节处穿刺法;并与临床分期及病理结果进行对照比较。结果经病理证实122例PCa各个临床分期TRUS有各自的特征表现:A期的声像图特点可分为外腺区的轻度回声不均及小低回声结节,B期的声像图特点主要为前列腺外腺区见低回声带、低及近等回声结节等,C期与D期的声像图表现比较相似,为多结节及弥漫浸润型,内外腺分界不清晰,前列腺内见弥漫散在沙粒状钙化强回声,或以周缘区明显,且形态不规则,包膜不完整,局部向外隆起结节等。彩色多普勒超声以血供增多为主,外腺区动脉及可疑结节内阻力指数(RI)增高。结论经直肠彩色多普勒超声能清晰显示前列腺内部结构,且能检测到前列腺癌内微小血管的血流速度及RI值,并有一定的临床分期的超声声像图特点,有助于提高对PCa临床分期的能力及诊断水平。Objective To observate the characteristic of transrectal color Doppler ultrasound in the diagnosis of prostate cancer（PCa）.Methods 122 patients with PCa were examined with transrectal color Doppler ultrasound.The size,area,abnormal echoes and the nodule sizes,and the amount of blood supply of prostate were observed.The speed of blood and the resistance index （RI） were measured as well.The method of transrectal ultrasound guided prostate biopsy is systematic 6 point adding suspected nodules.The ultrasonography of PCa were compared with the clinical stages and pathologic results.Results 122 patients were confirmed PCa by pathology.The different characteristics in different clinical stages TRUS of PCa：A stage characteristic of ultrasonography can be in heterogeneous-echo and low-echo nods peripheral area.B stage characteristic of ultrasonography can be the low-echo belt and low or equal-echo nod in prostate peripheral area,C and D stage have the similar ultrasonography,with multi-node and widespread infiltrate; The delimitation of inter-extre gland is unclear,the internal of prostate had the widespread sand granules calcifications,peripheral area is obviously,these nodules had irregular shape,incomplete capsule and local eminence; The blood supply mostly increased.The average systole peak flow-rate of peripheral area artery increased too.Concluions Transrectal color Doppler ultrasound could not only clear the inner structure of prostate,hut also detect the flow rate and RI of the tiny blood vessels in prostate.Having the characteristic of the ultrasonography,It can be incease the capable of clinical stages and diagnose of PCa.

关 键 词：经直肠超声 前列腺癌 临床分期 沙粒状钙化 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]