超微血管成像技术在前列腺良恶性结节鉴别诊断中的应用  

Application of superb microvascular imaging in differential diagnosis of benign and malignant prostate nodules

作　　者：何竹 陈珑[1] 江泉[2] 张渊[2] 单君[2] 施秀荣[2] 傅宇 HE Zhu;CHEN Long;JIANG Quan;ZHANG Yuan;SHAN Jun;SHI Xiurong;FU Yu(Department of Interventional Radiology,The First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu Province,China;Department of Ultrasound,Pudong New Area People’s Hospital of Shanghai City,Shanghai 201200,China)

机构地区：[1]苏州大学附属第一医院介入放射科,江苏苏州215006 [2]上海市浦东新区人民医院超声科,上海201200

出　　处：《肿瘤影像学》2022年第5期510-514,共5页Oncoradiology

基　　金：上海市浦东新区卫生健康委员会卫生计生科研项目(PW2021A-34);上海市浦东新区卫生和计划生育委员会重要薄弱学科(PWZbr2017-10)。

摘　　要：目的:探讨超微血管成像(superb microvascular imaging,SMI)技术通过检测前列腺结节内微小血流鉴别良恶性肿瘤的应用价值。方法:对拟行前列腺穿刺经直肠超声检查发现可疑结节的52例患者共65个结节,行SMI及超声造影(contrast-enhance ultrasound,CEUS)检查,分别对结节内的血流进行分级判定其良恶性,比较SMI及CEUS检测前列腺结节内微小血流的一致性,并以穿刺病理学结果为金标准,评估两种方法诊断前列腺癌的效能。结果:SMI及CEUS对前列腺结节内微小血流的检测具有良好的一致性,Kappa值为0.76。最终病理学检查结果显示,65个结节中恶性27个(临床显著前列腺癌26个,非显著前列腺癌1个),良性38个。SMI技术对前列腺结节的诊断灵敏度为74.1%(20/27),特异度为73.7%(28/38),准确度为73.8%(48/65),CEUS对前列腺结节的诊断灵敏度为85.2%(23/27),特异度为81.6%(31/38),准确度为83.1%(54/65),两种方法的诊断灵敏度、特异度和准确度比较差异均无统计学意义(χ^(2)=1.027,P=0.311;χ^(2)=0.682,P=0.409;χ^(2)=1.731,P=0.188)。结论:SMI对可疑前列腺结节的诊断效能及结节内微小血流的检测与CEUS检查有良好的一致性,其可用于协助前列腺可疑结节的鉴别诊断。Objective:To explore the application value of superb microvascular imaging(SMI)in differentiating benign and malignant tumors by detecting the tiny blood flow in prostate nodules.Methods:A total of 65 suspicious nodules in 52 patients who planned to undergo prostate puncture detected by transrectal ultrasound were examined by SMI and contrast-enhanced ultrasound(CEUS),and the blood flow in the nodules were graded to determine the diagnosis of their benign and malignant respectively.The consistency between SMI and CEUS in detecting the tiny blood flow in prostate nodules was compared,and the efficacy of the two methods in the diagnosis of prostate cancer was evaluated based on the biopsy pathological results as the gold standard.Results:SMI and CEUS showed good consistency in detecting the tiny blood flow in prostate nodules,with Kappa value of 0.76.The final pathological results showed that of the 65 nodules,27 were malignant(clinically significant prostate cancer in 26 cases,nonsignificant prostate cancer in 1 case)and 38 were benign.The diagnostic sensitivity,specificity and accuracy of SMI for prostate nodules were 74.1%(20/27),73.7%(28/38)and 73.8%(48/65)respectively.The diagnostic sensitivity,specificity and accuracy of CEUS were 85.2%(23/27),81.6%(31/38)and 83.1%(54/65)respectively,and there was no significant statistical difference in diagnostic sensitivity,specificity and accuracy between the two methods(χ^(2)=1.027,P=0.311;χ^(2)=0.682,P=0.409;χ^(2)=1.731,P=0.188).Conclusion:SMI has a good consistency with CEUS in the diagnosis of suspicious prostate nodules and the detection of tiny blood flow in nodules,it can be used to assist in the differential diagnosis of suspicious prostate nodules.

关 键 词：超微血管成像技术 超声造影 经直肠超声 前列腺结节 

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