经直肠实时超声弹性成像在前列腺活检中的应用价值

摘要

目的 探讨经直肠实时超声弹性成像(TRTE)在前列腺活检中的应用价值.方法 应用经直肠超声(TRUS)和TRTE检查68例疑诊前列腺癌患者,寻找病灶行目标活检,并行系统活检.比较前列腺癌检出率；比较系统活检和目标活检前列腺癌检出率.结果 TRUS检出可疑病灶36个,其中16例19个癌结节,检出率52.8％；TRTE检出可疑病灶30个,其中21例26个癌结节,检出率86.7％,TRTE和TRUS的前列腺癌检出率有明显差异(P＜0.01)；24例30个病灶行目标活检,活检点数71个,检出前列腺癌21例,检出率29.6％；68例系统活检点数472个,检出前列腺癌20例,检出率4.3％,两种活检方案的前列腺癌检出率有明显差异(P＜0.01).结论 TRTE可提高前列腺癌病灶的检出率,有助于引导目标活检,提高超声引导前列腺穿刺的活检效能.%Objective To explore the value of transrectal real-time elastography (TRTE) in prostate biopsy. Methods To examine 68 patients with suspected prostate cancer(PCa) by transrectal ultrasounography(TRUS) and TRTE. To do target biopsy in patients with lesions suspected PCa, and systematic biopsy in 68 cases at the same time. Results There were 36 lesions suspected PCa to be detected by TRUS, and 19 lesions in 16 patients were found,the detection rate of PCa was 52. 8%. There were 30 lesions suspected PCa to be detected by TRTE and 26 lesions in 21 patients were found, the detection rate of PCa was 86. 7% ,there was significant difference in the detection rate of PCa between TRUS and TRTE(P<0. 01). Target biopsy was done in 24 cases with 71 biopsy points, 21 PCa were diagnosed by pathology, the detection rate of PCa was 29. 6%; systematic biopsy was done in 68 cases with 472 biopsy points, 20 PCa were diagnosed in pathology, the detection rate of PCa was 4. 3% , there was significant difference in detection rate of PCa between target biopsy and systematic biopsy(P<0. 01). Conclusions TRTE was a good method which can help to determine the biopsy target for prostate biopsy and improve the detection rate of PCa.