经直肠超声造影鉴别诊断前列腺良、恶性结节

摘要

Objective To evaluate diagnostic value of transrectal gray scale contrast enhanced ultrasound (CEUS) in distinguishing benign from malignant nodes of prostate. Methods Thirty-three patients with 38 prostate nodes underwent real-time transrectal gray scale CEUS with SonoVue and contrast pulsed sequence (CPS). Contrast enhancement pattern of the prostate nodes were recorded and time-intensity curves (TIC) were drawn to calculate the parameters and difference between benign and malignant nodes. Results Twenty benign nodes (17 in inner gland) and 18 malignant ones (14 in external gland) were confirmed by pathology. Compared with normal peripheral zone, malignant lesions showed significantly earlier time to enhancement. The time to peak (TTP), accelerating time (ACT) and peak intensity (PI) of malignant lesions were lower than those of benign lesions (P<0.05).There was no significance in arrival time (AT) between the two groups (P>0.05). Conclusion Of all parameters in CEUS, TTP, ACT and PI are different between prostate benign and malignant lesions, and thus contribute to discriminate prostate cancer from benign diseases.%目的 探讨经直肠灰阶超声造影在前列腺良、恶性结节鉴别诊断中的价值. 方法采用SonoVue造影剂,结合新型对比脉冲序列(CPS)造影成像技术,对33例患者38个前列腺结节行实时超声造影,观察病灶造影增强方式,绘制时间-强度曲线(TIC),分析造影参数,比较前列腺良恶性结节之间的差异. 结果 良性结节20个,其中17个位于内腺;恶性结节18个,其中14个位于外腺.内腺良性结节超声造影增强方式以均匀增强为主,结节清晰,有环状增强;恶性结节增强早于正常外腺组织,以不均匀增强为主.恶性结节达峰时间及加速时间均短于良性结节(P<0.05),峰值强度低于良性结节(P<0.05),到达时间良、恶性间差异无统计学意义(P＞0.05). 结论超声造影中前列腺良、恶性结节中的达峰时间、加速时间、峰值强度等参数有一定差异,有助于鉴别诊断.