经直肠超声造影评估良性前列腺增生合并内腺结节治疗后血供变化的价值  

Value of transrectal contrast-enhanced ultrasound on evaluating blood supply changes after treatment of benign prostatic hyperplasia with inner gland nodules

作　　者：贾路 蒋新宇 姥义 郝明[1] 夏晓宇 JIA Lu;JIANG Xinyu;MU Yi;HAO Ming;XIA Xiaoyu(Department of Ultrasound,the 904th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army,Wuxi 213000,Jiangsu,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院超声科,江苏无锡213000

出　　处：《中国性科学》2022年第10期57-60,共4页Chinese Journal of Human Sexuality

摘　　要：目的探究经直肠超声造影(CEUS)评估良性前列腺增生(BPH)合并内腺结节经尿道前列腺电切术(TURP)治疗后血供变化的价值。方法选取中国人民解放军联勤保障部队第904医院2019年8月到2021年8月收治的156例BPH合并内腺结节患者作为研究对象。经直肠常规超声及CEUS检测所有患者治疗前后内腺结节血供变化,比较治疗前后患者的国际前列腺症状评分(IPSS)、最大尿流率、残余尿量及CEUS定量参数[造影剂到达时间(AT)、到达峰值时间(TTP)、峰值强度(PI)、曲线上升支斜率(β)],分析超声造影参数与微血管密度(MVD)的相关性。结果156例患者均为单发性内腺结节,常规超声检测治疗前后内腺结节回声均未发生明显变化;CEUS显示前列腺增生外腺区造影剂信号较弱,内腺区信号增强,内腺腺体可见结节状强灌注区,时间-强度曲线呈快进慢出型。治疗后患者IPSS、残余尿量均低于治疗前,最大尿流率高于治疗前(P<0.05);治疗后内腺结节CEUS参数PI、β均低于治疗前,TTP长于治疗前(P<0.05);治疗后内腺结节的MVD计数少于治疗前(P<0.05);内腺结节CEUS参数PI、β均与MVD计数呈正相关(r=0.688、0.474,P<0.001),TTP与MVD计数呈负相关(r=-0.648,P<0.001)。结论经直肠CEUS可清楚显示BPH病灶区血流灌注情况,且其与前列腺血管生成具备相关性,在评估BPH合并内腺结节治疗后血供变化方面的价值较高。Objective To explore the value of transrectal contrast-enhanced ultrasound(CEUS)on evaluating the blood supply changes of benign prostatic hyperplasia(BPH)with inner gland nodules after transurethral resection of the prostate(TURP).Methods A total of 156 patients with BPH complicated with inner gland nodules admitted to the 904th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army from August 2019 to August 2021 were selected as the research objects.Routine transrectal ultrasound and CEUS were used to detect the changes of blood supply in all patients before and after treatment.International prostate symptom score(IPSS),maximum urinary flow rate,residual urine volume and quantitative parameters of CEUS[contrast arrival time(AT),time to peak(TTP),peak intensity(PI),curve slope(β)]were compared before and after treatment.The ultrasonic imaging parameters and the correlation of microvascular density(MVD)were analyzed.Results 156 patients were all single inner gland nodules,and the echos of the inner gland nodules did not change significantly after conventional ultrasound examination.CEUS showed that the contrast agent signal in the outer gland area of benign prostatic hyperplasia was weaker and the signal in the inner gland area was enhanced,and the nodular strong perfusion area was observed in the inner glands and fast in and slow out were presented in time-intensity curve.After treatment,the IPSS and residual urine volume of patients were lower than those before treatment,while the maximum urine flow rate was higher than that before treatment(P<0.05);PI andβof inner gland nodules were all lower than those before treatment and TTP is longer than before treatment(P<0.05);the MVD count of inner gland nodules was less than that before treatment(P<0.05).The CEUS parameters such as PI andβof inner gland nodules were positively correlated with MVD count(r=0.688,0.474,P<0.001),while TTP was negatively correlated with MVD count(r=-0.648,P<0.001).Conclusions Transrectal CEUS can clearly show t

关 键 词：超声造影 良性前列腺增生 内腺结节 

分 类 号：R691[医药卫生—泌尿科学]