剪切波弹性成像预测良性前列腺增生患者α1受体阻滞剂疗效的临床研究  

Value of shear wave elastography in predicting the efficacy of α1-receptor blocker in patients with benign prostatic hyperplasia

作　　者：丁炎 李绍雷 徐卓群 阮钧 吴鹏西 周锋盛 王勇 DING Yan;LI Shaolei;XU Zhuoqun;RUAN Jun;WU Pengxi;ZHOU Fengsheng;WANG Yong(Department of Medical Ultrasound,Wuxi People’s Hospital of Nanjing Medical University,Jiangsu 214023,China)

机构地区：[1]南京医科大学附属无锡人民医院超声医学科,江苏省无锡市214023 [2]南京医科大学附属无锡人民医院泌尿外科,江苏省无锡市214023

出　　处：《临床超声医学杂志》2019年第12期895-898,共4页Journal of Clinical Ultrasound in Medicine

基　　金：无锡市卫计委青年项目(Q201809);无锡市医学青年人才项目(QNRC069)

摘　　要：目的探讨剪切波弹性成像(SWE)技术在预测良性前列腺增生患者α1受体阻滞剂疗效中的价值。方法选取我院拟行α1受体阻滞剂治疗的124例前列腺增生患者,根据疗效分为治疗有效组76例和治疗无效组48例。治疗前常规超声测量前列腺增生患者前列腺总体积和前列腺移行区体积;SWE测量前列腺组织弹性模量最大值、最小值,以及尿道旁前列腺组织弹性模量值,计算弹性模量变异系数(CV)。比较两组治疗前常规超声参数及剪切波弹性模量参数差异;绘制受试者工作特征(ROC)曲线,分析剪切波弹性模量参数预测其疗效的诊断效能。结果治疗有效组治疗前前列腺组织弹性模量最大值、尿道旁前列腺组织弹性模量值及剪切波CV明显低于治疗无效组,差异均有统计学意义(P<0.05);两组前列腺总体积、前列腺移行区体积及前列腺组织弹性模量最小值差异均无统计学意义。前列腺组织弹性模量最大值、尿道旁前列腺组织弹性模量及剪切波CV截断值分别为37.45 kPa、33.29 kPa、0.264,预测α1受体阻滞剂疗效的敏感性和特异性分别为85.71%、83.82%、88.89%和70.37%、66.07%、76.92%,其中剪切波CV预测疗效的曲线下面积大于前列腺组织弹性模量最大值和尿道旁前列腺组织弹性模量值,差异均有统计学意义(均P<0.05);前列腺组织弹性模量最大值预测疗效的曲线下面积大于尿道旁前列腺组织弹性模量值,但差异无统计学意义。三者联合应用预测疗效的敏感性(94.44%)和特异性(84.62%)均明显增高。结论SWE所测弹性模量值可作为预测良性前列腺增生患者α1受体阻滞剂疗效的指标,当多个弹性参数联合应用时预测价值更佳。ObjectiveTo investigate the value of shear wave elastography(SWE)in predicting the efficacy ofα1-receptor blocker elastic in patients with benign prostatic hyperplasia(BPH).MethodsA total of 124 BPH patients treated withα1-receptor blocker were enrolled,and they were divided into effective group(76 cases)and ineffective group(48 cases)according to the curative effect.Before treatment,the volume of total and transition zone prostate were measured by ultrasound,the maximum and minimum elastic modulus of periurethral prostatic tissue were measured by SWE.The coefficient of variation(CV)of the elastic modulus was obtained.The difference of elastic modulus between the two groups was statistically analyzed,and the value of elastic modulus in predicting therapeutic effect was evaluated by ROC curve.ResultsThe SWE value ofmaximum elasticity,periurethral and CV of elastic modulus were significantly lower in the effective group than those in theineffective group(all P<0.05).There were no significant differences in the volume of total and transition zone prostate,SWE ofminimum elastic modulus between the two groups.The optimal SWE of maximum elasticity,periurethral and CV cut-off values inpredicting therapeutic effect ofα1-receptor blocker were 37.45 k Pa,33.29 k Pa and 0.264,and the sensitivity were 85.71%,83.82%and 88.89%,and the specificity were 70.37%,66.07%and 76.92%,respectively.The AUC value of the SWE of CV in predicting therapeutic effect was higher than of the SWE of maximum elasticity and the periurethral tissue,and there werestatistically significant differences(both P<0.05).The AUC value of the SWE of maximum elasticity in predicting the therapeuticeffect was higher than that of the periurethral tissue,and there was no statistically significant difference.The sensitivity(94.44%)and specificity(84.62%)were significantly increased when all of the three parameters were used in predicting therapeutic effect.ConclusionThe elastic modulus of BPH measured by SWE is an indicator for predicting therapeutic effect of�

关 键 词：弹性成像 剪切波 前列腺增生 良性 Α1受体阻滞剂 

分 类 号：R445.1[医药卫生—影像医学与核医学] R697.3[医药卫生—诊断学]