中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2011, Vol. 33 ›› Issue (2): 175-179.doi: 10.3881/j.issn.1000-503X.2011.02.015

• 论著 • 上一篇    下一篇

经直肠实时组织弹性成像在前列腺癌诊断中的作用

张 艳,唐 杰,李岩密,费 翔,程流泉,何恩辉,李秋洋   

  1. 解放军总医院超声科, 北京 100853
  • 收稿日期:2010-09-29 出版日期:2011-04-10 发布日期:2011-04-10
  • 通讯作者: 唐杰 电话:010-66939532 E-mail:txiner@vip.sina.com

Role of Transrectal Real-time Tissue Elastography in the Diagnosis of Prostate Cancer

ZHANG   Yan, TANG   Jie, LI  Yan-Mi, FEI   Xiang, CHENG  Liu-Quan, HE  En-Hui, LI  Qiu-Yang   

  1. Department of Ultrasound, PLA General Hospital,Beijing 100853, China
  • Received:2010-09-29 Online:2011-04-10 Published:2011-04-10
  • Contact: TANG Jie Tel:-66939532 E-mail:txiner@vip.sina.com

摘要: 目的 探讨经直肠实时组织弹性成像(TRTE)在诊断前列癌(PCa)中的作用。方法 对84例疑为PCa并准备行穿刺活检的患者进行TRTE、直肠指诊(DRE)、经直肠超声(TRUS)及磁共振(MRI)检查,将弹性成像与其他检查及病理结果相比较。结果 84例患者中良性36例、恶性48例。TRTE诊断的灵敏度(91.7%)、特异度(72.2%)、准确率(83.3%)、阳性预测值(81.5%)及阴性预测值(86.7%)与TRUS(灵敏度85.4%、特异度63.9%、准确率76.2%、阳性预测值75.9%、阴性预测值76.7%)诊断的差异无统计学意义(P>0.05),其诊断的特异度72.2%高于MRI的44.4%(P=0.03)。TRTE诊断与病理的符合率和血清总前列腺特异抗原水平无关(P>0.05),其诊断的灵敏度随前列腺体积的增大而降低。对DRE检查呈软~中等质地的结节,TRTE诊断的特异度高于MRI(P=0.04)。对于PCa,TRTE诊断的灵敏度随肿瘤Gleason评分的增加而提高(P<0.05)。结论 TRTE可作为诊断PCa的一种重要的补充手段,为临床提供帮助。

关键词: 前列腺癌, 超声, 弹性成像

Abstract: Objective To investigate the role of transrectal real-time tissue elastography (TRTE) in the diagnosis of prostate cancer (PCa). Methods Eighty-four patients with suspected PCa and scheduled for prostate biopsies underwent TRTE, digital rectal examination (DRE), transrectal ultrasonography (TRUS), and magnetic resonance imaging (MRI). The findings of TRTE were compared with those of other examinations and pathological findings. Results Of these 84 patients, 36 had benign lesions and 48 had PCa. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 91.7%, 72.2%, 83.3%, 81.5%, and 86.7% for TRTE and 85.4%,63.9%,76.2%, 75.9%, and 76.7% for TRUS (P>0.05), while its specificity (72.2%) was significantly higher than that of MRI (44.4%) (P=0.03). The TRTE findings were not significantly correlated with the pathological findings and serum total prostate specific antigen (P>0.05), and the diagnostic sensitivity of TRTE decreased along with the enlargement of prostate. However, the diagnostic specificity of TRTE was higher than MRI for nodules with soft to medium texture (P=0.04).For PCa, the diagnostic sensitivity of TRTE increased when the Gleanson scores of tumors increased (P<0.05)Conclusion TRTE can be used as a diagnostic test to supplement clinical diagnosis of PCa.

Key words: prostate cancer, ultrasound, elastography

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