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目的:探讨微泡造影剂结合经直肠多普勒超声(contrast enhanced transrectual ultrasound,CETRUS)在经会阴前列腺穿刺活检中的临床意义。方法:对87例前列腺疾病患者在CE-TRUS后行经直肠B超引导下经会阴前列腺穿刺活检,穿刺标准依据2007年新修订的《中国泌尿外科疾病诊断治疗指南》确定。先行彩色多普勒超声检查,了解并记录前列腺局灶性病变部位、大小、数目、回声特征及彩色多普勒血流等情况。结果:87例确诊为前列腺癌和前列腺增生者分别为52例和35例,两者比较差异无统计学意义(P=0.617)。而以PSA≤20 ng/ml和PSA>20 ng/ml为标准行分层分析,发现PSA≤20 ng0ml者在CE-TRUS引导下经会阴前列腺穿刺阳性率高(P=0.041)。结论:CE-TRUS后经直肠B超引导下行经会阴前列腺穿刺活检是诊断前列腺癌的重要方法;PSA≤20 ng/ml者结合CE-TRUS行前列腺穿刺活检能提高前列腺癌穿刺阳性率。
Objective: To investigate the clinical significance of microbubble contrast agent combined with transrectal ultrasound (CETRUS) in perineal prostate biopsy. Methods: 87 patients with prostate disease underwent perineal prostate biopsy guided by transrectal B-ultrasound after CE-TRUS. The standard of puncture was determined according to the 2007 revised guideline of diagnosis and treatment of urological diseases in China. First color Doppler ultrasound to understand and record the location of focal lesion, size, number, echo characteristics and color Doppler blood flow and so on. Results: 87 cases of diagnosed as prostate cancer and benign prostatic hyperplasia were 52 cases and 35 cases, the difference was not statistically significant (P = 0.617). Stratification analysis of PSA≤20 ng / ml and PSA> 20 ng / ml showed that the positive rate of perineal prostate puncture under the guidance of CE-TRUS was higher (P = 0.041). CONCLUSIONS: Perineal prostate biopsy guided by transrectal B-ultrasound guided CE-TRUS is an important method for the diagnosis of prostate cancer. PSA-20 ng / ml combined with CE-TRUS prostate biopsy can improve the positive rate of prostate cancer.