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首页> 外文期刊>Ultrasound in Medicine and Biology >The utility of transrectal real-time elastography in the diagnosis of prostate cancer.
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The utility of transrectal real-time elastography in the diagnosis of prostate cancer.

机译：经直肠实时弹性成像在前列腺癌诊断中的应用。

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The aim of this study is to evaluate the diagnostic performance of transrectal real-time elastography (TRTE) to differentiate benign from malignant prostatic lesions, with pathologic diagnosis obtained by prostatic needle biopsy. Conventional gray scale transrectal ultrasonography (TRUS) and power Doppler ultrasonography (PDUS) were performed in 107 men who had elevated serum prostate-specific antigen level >4 ng/mL or abnormal findings on digital rectal examination. For baseline TRUS and PDUS imaging, the suspicion of carcinoma was scored using previously proposed five-point subjective scale. For TRTE imaging, we used newly adopted five-point subjective scale based on the degree and distribution of strain in relation to hypoechoic area, which simultaneously displayed on B-mode image. All patients underwent transperineal systematic 8-cores biopsies, as well as up to four cores of targeted biopsy from suspicious area by TRUS, PDUS and/or TRTE. The samples were diagnosed pathologically and compared with the findings of TRUS, PDUS and TRTE. Prostate cancer was detected in 40 (37%) of 107 patients. When a cutoff point of 3 (displaying focal asymmetric lesion without strain not related to hypoechoic lesion) was used, TRTE had 68% sensitivity, 81% specificity and 76% accuracy. TRTE was comparable with PDUS (70% sensitivity, 75% specificity and 73% accuracy) and had significantly higher sensitivity than TRUS (68% vs. 50%, p = 0.027). Combination of TRTE with PDUS increased sensitivity to 78%. The detection rate of directed biopsy from suspicious area in either TRTE or PDUS (TRTE+PDUS-directed biopsy) was 29% (31/107) by patient and was comparable with systematic biopsy (31%, 33/107, p = 0.86), whereas the detection rate of TRTE+PDUS-directed biopsy by core (55/111, 50%) was significantly higher than systematic biopsy (132/856, 15%, p < 0.0001). For assessing prostatic lesions, TRTE with B-mode image-based scoring had almost the same diagnostic performance as PDUS. Although TRTE+PDUS-directed biopsy detected comparable number of cancers with systematic biopsy, both techniques should be used supplementarily for minimizing the number of missing cancers.
机译：这项研究的目的是评估经直肠实时弹性成像（TRTE）区分良性和恶性前列腺病变的诊断性能，并通过前列腺穿刺活检获得病理诊断。在107名血清前列腺特异性抗原水平升高> 4 ng / mL或在直肠指检中发现异常的男性中进行了常规的灰度经直肠超声检查（TRUS）和功率多普勒超声检查（PDUS）。对于基线TRUS和PDUS成像，使用先前提出的五点主观量表对癌症的怀疑进行评分。对于TRTE成像，我们根据应变相对于低回声区域的程度和分布采用了新近采用的五点主观量表，并将其同时显示在B型图像上。所有患者均接受经会阴系统性8芯活检，以及TRUS，PDUS和/或TRTE进行的多达4芯可疑区域靶向活检。对样本进行病理诊断，并与TRUS，PDUS和TRTE的发现进行比较。 107名患者中有40名（37％）检测到前列腺癌。当使用截止点3（显示局灶性不对称病变而无与低回声病变无关的应变）时，TRTE的灵敏度为68％，特异性为81％，准确度为76％。 TRTE可与PDUS相媲美（灵敏度为70％，特异性为75％，准确度为73％），其灵敏度明显高于TRUS（68％与50％，p = 0.027）。 TRTE与PDUS的组合可将敏感性提高到78％。无论是TRTE还是PDUS（TRTE + PDUS指导的活检），可疑区域的直接活检的检出率为29％（31/107），与系统活检的检出率相当（31％，33/107，p = 0.86） ，而针对核心的TRTE + PDUS导向活检的检出率（55/111，50％）显着高于系统活检（132/856，15％，p <0.0001）。为了评估前列腺病变，具有基于B型图像评分的TRTE具有与PDUS几乎相同的诊断性能。尽管TRTE + PDUS指导的活检与系统活检可检测到相当数量的癌症，但应同时使用两种技术以最大程度地减少遗漏的癌症。

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