Bellon J, Wallner K, Ellis W, Russell K, Cavanagh W, Blasko J
Department of Radiation Oncology, University of Washington, Seattle, USA.
Int J Radiat Oncol Biol Phys. 1999 Feb 1;43(3):579-81. doi: 10.1016/s0360-3016(98)00466-0.
To determine the necessity of preoperative evaluation of pubic arch interference in patients with small prostate volumes.
CT scans from 97 consecutive, unselected patients with stage T1 or T2 prostatic carcinoma who had transperineal I-125 or Pd-103 implants at the University of Washington in 1997 were analyzed for pubic arch interference. Transrectal ultrasound (TRUS) was performed with 6.0-MHz transducer with the patient in the lithotomy position and the patient's thighs vertical, similar to that used during the implant procedure. CT scans were obtained with the patient in the supine position, with 0.5-cm images taken at every 0.5 cm. To check for potential arch interference, the largest prostate cross-section was overlaid on the narrowest portion of the pubic arch. The overlap of the pubic arch and the prostate margin is measured at right angles to the inner pubic surface. The prostate volume obtained from the TRUS images was compared with the degree of pubic arch interference in order to determine whether TRUS volume predicted for interference.
There was considerable variability in pubic arch interference between patients. The mm of pubic arch overlap with the prostatic margin varied from -11 mm to 20 mm. Patients with larger prostate volumes generally had more pubic arch interference, but the degree of interference was only loosely related to the prostate volume (r = 0.46).
The degree of pubic arch interference is highly variable from one patient to the next and the TRUS volume cannot reliably predict patients who do or do not need a pelvic CT to detect potential arch interference.
确定对前列腺体积较小的患者进行耻骨弓干扰术前评估的必要性。
分析了1997年在华盛顿大学连续97例未经挑选的T1或T2期前列腺癌患者的CT扫描图像，这些患者接受了经会阴I-125或Pd-103植入治疗，以评估耻骨弓干扰情况。使用6.0MHz探头进行经直肠超声（TRUS）检查，患者取截石位，大腿垂直，与植入手术时的体位相似。患者取仰卧位进行CT扫描，每隔0.5cm获取0.5cm厚的图像。为检查潜在的弓状干扰，将最大的前列腺横截面覆盖在耻骨弓最窄处。在与耻骨内表面成直角的方向上测量耻骨弓与前列腺边缘的重叠情况。将从TRUS图像获得的前列腺体积与耻骨弓干扰程度进行比较，以确定TRUS体积是否能预测干扰情况。
患者之间耻骨弓干扰存在很大差异。耻骨弓与前列腺边缘的重叠毫米数从-11mm到20mm不等。前列腺体积较大的患者通常耻骨弓干扰更大，但干扰程度与前列腺体积仅存在松散的相关性（r = 0.46）。
耻骨弓干扰程度在患者之间差异很大，TRUS体积不能可靠地预测哪些患者需要或不需要进行盆腔CT检查以检测潜在的弓状干扰。
