经直肠剪切波弹性成像技术在前列腺癌与良性前列腺增生鉴别诊断中的应用价值

发布时间：2018-06-17 11:24

本文选题：剪切波弹性成像 + 弹性模量　；参考：《中国超声医学杂志》2017年11期

【摘要】：目的探讨经直肠剪切波弹性成像技术在前列腺癌与良性前列腺增生鉴别诊断中的应用价值。方法选取127例疑诊为前列腺癌的患者行经直肠超声检查和经直肠剪切波弹性成像检查,测量其弹性模量值获得病变的弹性最大值(Emax值)、平均值(Emea值)后,行经直肠超声引导下穿刺活检,以穿刺病理结果为金标准,绘制ROC曲线图,取得Emax值、Emea值的弹性界值。评价经直肠剪切波弹性成像技术在前列腺良恶性病变鉴别诊断中的应用价值。结果病理诊断37例为前列腺癌,90例为良性前列腺增生。前列腺癌的Emax值和Emea值分别为(65.07±13.49)kPa、(44.05±7.62)kPa,良性前列腺增生的Emax值和Emea值分别为(51.64±10.16)kPa、(36.55±5.92)kPa,两组间的Emax值和Emea值的差异具有统计学意义(t=11.113、10.444,P均0.05)。Emax值和Emea值在ROC曲线下面积分别为0.941、0.925。取53.25、42.35kPa作为Emax值和Emea值的诊断界值时,其灵敏度分别为89.2%、91.9%,特异度分别为95.6%、82.2%;经直肠剪切波弹性成像鉴别诊断前列腺良恶性病灶的灵敏度、特异度、准确度分别为78%、80%、79.5%,明显高于经直肠二维超声检查,两者检查方法对前列腺良恶性病变鉴别诊断的灵敏度、特异度、准确度相比具有统计学意义(χ~2=0.047、0.009、0.001,P0.05)。结论经直肠剪切波弹性成像技术根据病灶的弹性模量值定量评价病灶的硬度,在前列腺癌与良性前列腺增生鉴别诊断中有较高的应用价值,有助于提高前列腺癌的检出率。
[Abstract]:Objective to evaluate the value of transrectal shear wave elastography in the differential diagnosis of prostate cancer and benign prostatic hyperplasia (BPH). Methods 127 patients with suspected prostate cancer were examined by transrectal ultrasound and transrectal shear wave elastography. Transrectal ultrasound guided biopsy was performed. The ROC curve was drawn according to the results of biopsy and the elastic bounds of Emax and Emea were obtained. To evaluate the value of transrectal shear wave elastography in differential diagnosis of benign and malignant prostate diseases. Results 37 cases were diagnosed as prostate cancer and 90 cases were benign prostatic hyperplasia. The Emax and EMEA of prostate cancer were 44.05 卤7.62kPa44.05 卤7.62kParespectively, and the Emax and EMEA of benign prostatic hyperplasia were 51.64 卤10.16kPa36.55 卤5.92kParespectively. The difference of Emax and EMEA between the two groups was statistically significant. The area of Emax and EMEA under the ROC curve was 0.941 卤0.925, respectively. When 53.25 ~ 42.35 KPA was taken as the diagnostic threshold of Emax and EMEA, the sensitivity was 89.2and 91.9, and the specificity was 95.6 and 82.2 respectively. The sensitivity and specificity of transrectal shear wave elastography in differential diagnosis of benign and malignant prostatic lesions were analyzed. The accuracy of the two dimensional ultrasonography was significantly higher than that of transrectal ultrasonography. The sensitivity, specificity and accuracy of the two methods in differential diagnosis of benign and malignant prostate lesions were statistically significant (蠂 ~ 2 / 0. 047 ~ 0. 009 ~ 0. 001 P 0. 05). Conclusion the technique of transrectal shear wave elastic imaging can quantitatively evaluate the hardness of the lesion according to the elastic modulus of the lesion. It is of great value in the differential diagnosis of prostate cancer and benign prostatic hyperplasia. It is helpful to improve the detection rate of prostate cancer.
【作者单位】：兰州大学第二医院超声3科;
【基金】：甘肃省卫生行业科研计划项目(No.GSWSKY-2014-34)
【分类号】：R445.1;R697.3;R737.25

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