实用老年医学

实用老年医学 ›› 2024, Vol. 38 ›› Issue (6): 617-620.doi: 10.3969/j.issn.1003-9198.2024.06.017

• 临床研究 • 上一篇    下一篇

经直肠超声剪切波弹性成像技术鉴别老年前列腺良恶性结节的应用价值

李雅婷, 王会, 刘小静, 何萍, 任爱荣, 何睿, 王美娟, 姜学忠   

  1. 210024 江苏省南京市,南京医科大学附属老年医院(江苏省省级机关医院)超声诊断科
  • 收稿日期:2023-07-31 出版日期:2024-06-20 发布日期:2024-06-19
  • 通讯作者: 姜学忠,Email:drjiang210024@126.com

Application of transrectal shear wave elastography in differentiating benign and malignant prostatic nodules in the elderly

LI Yating, WANG Hui, LIU Xiaojing, HE Ping, REN Airong, HE Rui, WANG Meijuan, JIANG Xuezhong   

  1. Department of Ultrasound,the Affiliated Geriatric Hospital of Nanjing Medical University (Jiangsu Province Official Hospital), Nanjing 210024,China
  • Received:2023-07-31 Online:2024-06-20 Published:2024-06-19
  • Contact: JIANG Xuezhong, Email: drjiang210024@126.com

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摘要： 目的 探讨经直肠超声剪切波弹性成像(transrectal shear wave elastography,TRSWE)鉴别老年前列腺良恶性结节的应用价值。方法 纳入83例经TRSWE检查后行穿刺活检的前列腺病变病人,比较良、恶性病变的杨氏模量值;分析杨氏模量值与前列腺癌Gleason评分之间的关系。结果 恶性组的年龄、杨氏模量最大值(Emax)、最小值(Emin)、平均值(Emean)均高于良性组,差异具有统计学意义(均P＜0.05)。Emax、Emean、Emin诊断前列腺癌的AUC和95%CI分别为0.794(0.691～0.875)、0.740(0.632～0.830)、0.634(0.521～0.737);Emax、Emean和Emin的最佳截断值分别为69.2、50.8、30.7 kPa。Gleason评分8～10分病人(高危组)Emax、Emean均大于Gleason评分6分病人(低危组)和良性组,差异有统计学意义(均P＜0.05);良性组与低危组之间Emax、Emean差异无统计学意义,各组之间Emin的差异无统计学意义(均P＞0.05)。结论 TRSWE对于鉴别良恶性前列腺结节具有一定的价值,在一定程度上能够提示肿瘤的病理分级,为前列腺癌病人临床治疗方案的制订提供影像学依据。

关键词: 超声检查, 前列腺癌, 剪切波弹性成像, 杨氏模量, Gleason评分

Abstract: Objective To explore the value of transrectal shear wave elastography (TRSWE) in differentiating benign and malignant prostatic nodules in the elderly patients. Methods Young’s modulus of benign and malignant prostate diseases was compared in 83 patients with prostate diseases who underwent biopsy after TRSWE examination. The relationship between Young’s modulus and Gleason of prostate cancer was analyzed. Results The age, maximum value (Emax), minimum value (Emin) and the average value (Emean) of Young’s modulus of the malignant lesions were higher than those of benign lesions, and the difference was statistically significant (P<0.05). AUC and 95%CI of Emax, Emean and Emin to predict prostate cancer were 0.794 (0.691-0.875), 0.740 (0.632-0.830), and 0.634 (0.521-0.737), respectively. The cutoff value of Emax, Emean and Emin was 69.2 kPa, 50.8 kPa and 30.7 kPa, respectively. The Emax and Emean values in the high-risk group score were higher than those in the low-risk group (Gleason score was 6) and the benign group (all P<0.05). The differences in Emax and Emean between the benign group and low-risk group were not statistically significant, and the difference in Emin among all groups was not statistically significant (all P>0.05). Conclusions TRSWE shows high value in the diagnosis of prostate cancer, and it can also indicate the pathological grade of the tumor and provide an imaging evidence for the formulation of clinical treatment plans for prostate cancer.

Key words: ultrasound, prostate cancer, shear wave elastography, Young’s modulus, Gleason score

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