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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

35

期数:

2018年10

页码:

895-898

栏目:

临床研究

出版日期:

2018-10-05

文章信息/Info

Title:

Diagnostic value of transrectal elastography combined with transrectal contrast-enhanced ultrasound in prostate carcinoma

作者:

梅将军¹; 江　怡²; 张　波¹; 王　颖²; 赵云歆²; 姚广力²; 蔡秋琼²; 康慧莉²

（1.同济大学医学院，上海　200092；2.上海市浦东新区浦南医院超声科，上海　200015）

Author(s):

MEI Jiang-jun¹; JIANG Yi²; ZHANG Bo¹; WANG Ying²; ZHAO Yun-xin²; YAO Guang-li²; CAI Qiu-qiong²; KANG Hui-li²

（1.Tongji University School of Medicine，Shanghai 200092，China；2.Department of Ultrasound，Shanghai Punan Hospital of Pudong New District，Shanghai 200015，China）

关键词:

前列腺癌; 经直肠超声弹性成像; 超声造影; 前列腺特异抗原

Keywords:

prostatic carcinoma; transrectal ultrasound elastography; contrast-enhanced ultrasonography; prostate specific antigen

分类号:

R737.25

DOI:

10.7683/xxyxyxb.2018.10.011

文献标志码:

A

摘要:

目的　探讨经直肠超声弹性成像（TRE）联合经直肠超声造影（TR-CEUS）诊断前列腺癌（PCa）的价值。方法　选择2015年5月至2017年5月上海市浦东新区浦南医院收治的疑似PCa患者107例，根据前列腺活体组织检查结果将患者分为良性病变组（n=48）和PCa组（n=59）。记录患者基本信息，检测血清前列腺特异性抗原（PSA）水平，并进行TRE、TR-CEUS检查，记录病变应变指数（SI）、始增时间（AT）、达峰时间（TTP）、曲线上升支斜率（β），分析TR-CEUS和TRE诊断PCa的效能。结果　良性病变组和PCa组患者的年龄和结节直径比较差异无统计学意义（P>0.05）；PCa组患者血清PSA水平、SI、β显著高于良性病变组，AT和TTP显著短于良性病变组（P<0.05）。血清PSA水平和SI、β升高与PCa显著相关（P<0.05）。TRE诊断PCa的敏感度为71.19%，特异度为70.83%；TR-CEUS诊断PCa的敏感度为76.27%，特异度为72.92%。SI诊断PCa的曲线下面积（AUC）为0.776，敏感度为59.20%，特异度为63.40%；β诊断PCa的AUC为0.796，敏感度为64.40%，特异度为73.80%；SI和β联合诊断PCa的AUC为0.874，敏感度为85.42%、特异度为82.66%。SI和β联合诊断PCa的敏感度和特异度高于TRE、TR-CEUS及SI、β单独诊断（P<0.05），AUC高于SI、β单独诊断（P<0.05）。结论　SI和β联合诊断PCa的准确性较高，有望成为理想的客观诊断指标。

Abstract:

Objective　To explore the diagnostic value of transrectal ultrasound elastography（TRE） combined with transrectal contrast-enhanced ultrasonography（TR-CEUS） in prostatic carcinoma(PCa).Methods　A total of 107 patients with suspected PCa admitted to Punan Hospital of Pudong New Area from May 2015 to May 2017 were enrolled.The patients were divided into benign lesion group（n=48） and PCa group（n=59） according to the results of prostate biopsy.The patients′ basic information was recorded，the serum prostate specific antigen（PSA）level was detected，the TRE and TR-CEUS were performed and the strain index（SI），initial growth time（AT），peak time（TTP） and the slope of ascending branch of curve（β） were recorded.The diagnostic efficacy of TR-CEUS and TRE in PCa was analyzed.Results　There was no significant difference in age and nodal size between the benign lesion group and PCa group（P>0.05）；the PSA，SI and β in PCa group were significantly higher than those in benign lesion group，and the AT and TTP were significantly shorter than those in benign lesion group（P<0.05）.The increase of serum PSA and SI，β was significantly correlated with PCa（P<0.05）.The sensitivity and specificity of TRE for the diagnosis of PCa was 71.19%，70.83% respectively.The sensitivity and specificity of TR-CEUS for the diagnosis of PCa was 76.27%，72.92% respectively.The area under the curve（AUC） of SI for diagnosing PCa was 0.776，and the sensitivity，specificity of SI was 59.20%，63.40%；the AUC of β value for diagnosing PCa was 0.796，and the sensitivity，specificity of β was 64.40%，73.80%；the AUC of SI combined with β for diagnosing PCa was 0.874，and the sensitivity，specificity of SI combined with β was 85.42%，82.66%.The sensitivity and specificity of combined diagnosis of SI and β for PCa were significantly higher than those of TRE，TR-CEUS，and SI，β alone diagnosis，and the AUC was significantly higher than that of SI and β alone diagnosis（P<0.05）.Conclusion　The combination of SI and β has the higher accuracy in diagnosing PCa，which is expected to be an ideal objective diagnostic index.

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更新日期/Last Update: 2018-10-05