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目的探讨经直肠实时超声组织弹性成像(TRTE)在诊断前列腺癌中的应用价值。方法对45例可疑前列腺癌患者于穿刺前行TRTE结合经直肠超声(TRUS)检查前列腺,并在其引导下穿刺活检,与病理结果对照。结果 45例患者中良性24例,前列腺癌21例,TRTE诊断前列腺癌灵敏度80.95%(17/21),特异度66.67%(16/24),准确度73.33%(33/45),阳性预测值68%(17/25),阴性预测值85%(17/20);TRUS诊断灵敏度80.95%(17/21),特异度58.33%(14/24),准确度68.89%(31/45),阳性预测值60.71%(17/28),阴性预测值82.35%(14/17);TRTE+TRUS诊断前列腺癌的灵敏度85.71%(18/21),特异度83.33%(20/24),准确度82.20%(37/45),阳性预测值89.47%(17/19),阴性预测值84.6%(22/26)。TRUS+TRTE检查的特异度、准确度及阳性预测值均高于单独的TRUS或TRTE诊断,且差异具有显著性(χ~2=4.02、4.62、4.85、3.91、5.16、5.94,P<0.05)。结论 TRTE是一种无创评价组织弹性的显像方式,与二维超声、彩色血流信息联合诊断具有简单、无创、经济的优点,能很好地满足临床的需求,可为提高前列腺穿刺活检阳性率提供新的方法和手段。
Objective To investigate the value of transrectal real-time ultrasound tissue elastography (TRTE) in the diagnosis of prostate cancer. Methods 45 cases of suspected prostate cancer patients underwent TRTE combined with transrectal ultrasound (TRUS) before prostatectomy and biopsy was performed under the guidance of them. The results were compared with the pathological results. Results Among the 45 patients, 24 were benign and 21 were prostate cancer. The sensitivity, specificity and accuracy of TRTE in diagnosis of prostate cancer were 80.95% (17/21), 66.67% (16/24) and 73.33% (33/45), respectively. The positive predictive value The sensitivity of TRUS was 80.95% (17/21), the specificity was 58.33% (14/24), the accuracy was 68.89% (31/45), the accuracy was 68.8% (17/25), the negative predictive value was 85% The positive predictive value was 60.71% (17/28) and negative predictive value was 82.35% (14/17) respectively. The sensitivity and specificity of TRTE + TRUS in diagnosing prostate cancer were 85.71% (18/21) and 83.33% (20/24) 82.20% (37/45), positive predictive value 89.47% (17/19), negative predictive value 84.6% (22/26). The specificity, accuracy and positive predictive value of TRUS + TRTE were higher than those of TRUS or TRTE alone (χ ~ 2 = 4.02,4.62,4.85,3.91,5.16,5.94, P <0.05) . Conclusion TRTE is a non-invasive evaluation of tissue elasticity imaging method, and two-dimensional ultrasound, color flow information diagnosis is simple, noninvasive, economical advantages, can meet the clinical needs well, can improve the positive of prostate biopsy Rate provides new ways and means.