论文部分内容阅读
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。
Objective: To investigate the value of transrectal real-time tissue elastography (RTE) in the differential diagnosis of prostate cancer in patients with elevated PSA. Methods: The patients with prostate cancer were divided into two groups according to the transrectal ultrasonography. Suspected prostate cancer patients were divided into two groups with peripheral nodules and no obvious nodules. RTE examination was performed. According to the characteristics of the elastic strain map of the prostate, elastography of the prostate It is divided into 5 grades. Followed by ultrasound-guided prostate biopsy, and the pathological results for the gold standard ROC curve were drawn. Results: Totally 90 patients with excellent elastography were included in the study. Among them, 42 patients showed no obvious hypoechoic nodules in the peripheral zone and 48 patients showed hypoechoic nodules in the peripheral zone, of which 13 were multiple nodules. Of the 90 patients, a total of 105 elastic scores were obtained, of which 55 were ultimately confirmed to be benign and 50 were malignant. The ROC area under the ROC curve for the two groups was 0.58 and 0.83, respectively. To ES≥4 points as a diagnostic threshold to identify benign and malignant prostate, RTE in the two groups of differential diagnosis accuracy, negative predictive value was significantly different (P <0.05). CONCLUSIONS: RTE is of great value in the differential diagnosis of prostate cancer in patients with elevated PSA, especially in patients with nodules in the peripheral zone.