经直肠前列腺超声造影对前列腺癌诊断的应用价值  

Application value of transrectal prostate ultrasonic in the diagnosis of prostate cancer

作　　者：高越 曹军英[1] 毕名森 于馨[1] 里子彧[1] GAO Yue;CAO Junying;BI Mingsen;YU Xin;LI Ziyu(Department of Ultrasound,General Hospital of Shenyang Military Command of the PLA,Shenyang 110016,P.R.China)

机构地区：[1]中国人民解放军沈阳军区总医院超声科,辽宁沈阳110016

出　　处：《医学影像学杂志》2018年第11期1914-1917,共4页Journal of Medical Imaging

摘　　要：目的探讨经直肠前列腺超声造影对前列腺癌诊断的应用价值。方法分析我院70例临床怀疑前列腺癌患者,经直肠指检发现异常,血清前列腺特异性抗原(PSA)均持续性异常增高,PSA> 4. 0μg/ml,经TRUS及MRI检查异常者,年龄52～92岁,中位年龄72岁。其中研究组30例患者,先行前列腺超声造影选择靶区,再经直肠超声引导下行12+X针(靶向区加1～2针)穿刺活检;另外对照组40例患者,直接进行经直肠超声引导下常规12针穿刺活检,对比两组患者前列腺癌穿刺活检的阳性率。根据PSA值不同将患者分为3组,分析各组靶向区的检出率。结果研究组前列腺癌结节超声造影表现为早期高增强,早消退或不规则增强。前列腺癌穿刺活检阳性率为53. 3%,明显高于对照组32. 5%(P <0. 05); PSA 4. 1～20μg/ml中靶向区的检出率为25%,PSA 20. 1～40μg/ml中靶向区的发现率为42. 9%,PSA> 40μg/ml中靶向区的检出率为80%,差异有统计学意义(P <0. 05)。结论经直肠前列腺超声造影能有效提高前列腺穿刺活检阳性率及前列腺癌的诊断率。超声造影在前列腺多点穿刺中真正具有可视、安全、结果可靠、漏诊率低的优点。Objective To evaluate the value of transrectal contrast-enhanced ultrasound in the diagnosis of prostate cancer.Methods 70 patients with clinically suspected prostate cancer in our hospital were analyzed. The rectal examination found that prostate specific antigen （PSA） was abnormal （being persistently abnormal, PSA〉4.0 μg/ml）. TRUS and MRI showed the abnormalities in those patients, aged from 52 to 92 years old, with median age of 72 years. 30 patients in study group were firstly subjected to prostatic ultrasound contrast selection targeting, and then, to the trans rectal ultrasound-guided needle biopsy in 12 ＋X（Target zone with 1-2 needle）. The other 40 patients in the control group directly underwent Trans rectal ultrasound-guided routine 12 needle biopsy. The positive rates of prostate biopsy in the two groups were compared. Patients were divided into 3 groups by PSA and the discovery rate of every group was analyzed.Results The contrast-enhanced ultrasound findings of prostate cancer nodules in the study group were early enhanced, early fade or irregular enhancement. The positive rate of prostate biopsy was 53.3%, significantly higher than that in the control group 32.5% （ P 〈0.05）. The complication rate in the two group by the needle biopsy was no significant difference （ P 〉0.05）. The discovery rate of PSA 4.1-20 ng/ml was 25%. The discovery rate of PSA 20.1-40 ng/ml was 42.9%. The discovery rate of PSA 20.1-40 ng/ml was 80%. There was significant difference among them （ P 〈0.05）.Conclusion Contrast-enhanced transrectal ultrasound can effectively improve the positive rate of prostate biopsy and the diagnostic rate of prostate cancer. Contrast-enhanced ultrasound has the advantages of visibility, safety, reliability and low rate of the missed diagnosis in multi-point prostate puncture.

关 键 词：经直肠超声造影 前列腺穿刺活检 前列腺癌 

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]