摘要
目的：探讨经直肠实时组织弹性成像（RTE）在PSA升高患者中鉴别诊断前列腺癌的价值。方法：根据直肠超声检查将PSA升高、怀疑前列腺癌患者分为外周带结节与未见明显结节两组，再行RTE检查，根据前列腺弹性应变图的特点，前列腺弹性成像（ES）将其分为5级评分。随后行超声引导下前列腺穿刺活检，并以病理结果为金标准分别绘制ROC曲线。结果：90例弹性成像质量好的患者最终入选研究，其中，42例患者外周带未见明显低回声结节，48例患者外周带可见低回声结节，其中13例为多发结节。90例患者总计获得105个弹性评分，其中最终证实良性55个，恶性50个，两组患者RTE在ROC曲线下面积分别为0.58和0.83。以ES≥4分作为鉴别前列腺良恶性的诊断界值，RTE在两组中鉴别诊断的准确度、阴性预测值存在显著性差异（P<0.05）。结论：RTE在PSA升高，特别是在外周带存在结节的患者的前列腺癌的鉴别诊断中具有重要价值。
Abstract
Objective: To evaluate the value of real-time elastography(RTE) in the differential diagnosis of prostate cancer(PCa). Methods: Patients with raised PSA level suspected of PCa underwent transrectal ultrasound(TRUS) and RTE examinations. Based on the TRUS and PSA level, the patients were divided into two groups: group 1: PSA≥10.0 ng/mL, without nodular lesion in the peripheral zone, group 2: PSA≥4.0 ng/mL, with nodular lesion in the peripheral zone. RTE were classified into 5 elastography scoring(ES)，comparing with the results of prostate biopsy pathological findings. ROC curves were drawn to evaluate their differential diagnostic results in the two groups. Result: High quality images of RTE were obtained in 90 patients of 105 cases. According to the pathological results, the areas under the ROC curve were 0.58 and 0.83 respectively. Taking ES≥4 as the cutoff, there were significant differences in accuracy and negative predictive value(P<0.05) between the two groups. Conclusion: RTE is helpful to the differential diagnosis of prostate cancer, especially those with peripheral zone lesions.
关键词
前列腺肿瘤 /
超声检查 /
多普勒 /
彩色
Key words
Prostatic neoplasms /
Ultrasonography /
Doppler /
color
詹 嘉;朱 隽;柴启亮;汪东亚;陈 悦.
PSA升高患者经直肠实时组织弹性成像鉴别诊断前列腺癌[J]. 中国临床医学影像杂志. 2014, 25(6): 429-432
ZHAN Jia;ZHU Jun;CHAI Qi-liang;WANG Dong-ya;CHEN Yue.
Transrectal real-time elastography in the differential diagnosis of prostate cancer in patients with raised PSA level[J]. Journal of China Clinic Medical Imaging. 2014, 25(6): 429-432
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