Goossen Tjerk E B, de la Rosette Jean J M C H, Hulsbergen-van de Kaa Christina A, van Leenders Geert J L H, Wijkstra Hessel
Department of Urology, University Medical Centre Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Eur Urol. 2003 Feb;43(2):124-31. doi: 10.1016/s0302-2838(02)00582-1.
The objective of this study is to define enhancement characteristics that correlate to the presence of prostate cancer (PCa) and to evaluate the value of these characteristics in the localization of prostate cancer.
29 patients with proven prostate malignancy, scheduled for radical prostatectomy, underwent an ultrasound examination prior to surgery. A bolus injection of contrast agent was administered intravenously. The distribution of the contrast enhanced blood to the prostate was monitored using Transrectal Contrast Enhanced Power Doppler Ultrasound. Fixed protocols and settings were used for all patients. The percentage of a selected area that showed enhancement was observed in time. The resulting enhancement curves were described using the parameters time to start, time to the maximum of the enhancement, the maximum value of the enhancement, and the rise time of the enhancement. Three evaluation-protocols divided the prostate into a number of areas of interest: into two areas using the Left-Right (LR) and Dorsal-Ventral (DV) protocols and into four areas using the Quadrant-protocol (Q). The enhancement parameters of the areas of interest were compared to identify the most affected area. The results were compared to the histopathological findings.
For the LR-protocol, the minimal time to peak proved to be the most predictive parameter for selecting the major malignant area. 78% of the patients were diagnosed correctly (N=23). Accurate localization of the major malignancy in either the ventral or dorsal side of the prostate was not feasible using the current protocol.
Malignancies can be accurately localized in either the left or the right side of the prostate based on the time to the maximum of the enhancement. An accurate discrimination between malignancies in either the dorsal or ventral side of the prostate cannot be performed. This is most likely due to anatomical differences between the dorsal and ventral area.
本研究的目的是确定与前列腺癌（PCa）存在相关的增强特征，并评估这些特征在前列腺癌定位中的价值。
29例经证实患有前列腺恶性肿瘤且计划进行根治性前列腺切除术的患者在手术前接受了超声检查。静脉内推注造影剂。使用经直肠造影增强功率多普勒超声监测造影剂增强的血液在前列腺中的分布。所有患者均使用固定的方案和设置。及时观察选定区域显示增强的百分比。使用开始时间、增强最大值时间、增强最大值以及增强上升时间等参数来描述所得的增强曲线。三种评估方案将前列腺划分为多个感兴趣区域：使用左右（LR）和背腹（DV）方案划分为两个区域，使用象限方案（Q）划分为四个区域。比较感兴趣区域的增强参数以确定受影响最大的区域。将结果与组织病理学结果进行比较。
对于LR方案，峰值最短时间被证明是选择主要恶性区域的最具预测性的参数。78%的患者被正确诊断（N = 23）。使用当前方案无法准确确定前列腺腹侧或背侧的主要恶性肿瘤位置。
基于增强最大值时间，可以准确地将恶性肿瘤定位在前列腺的左侧或右侧。无法对前列腺背侧或腹侧的恶性肿瘤进行准确区分。这很可能是由于背侧和腹侧区域的解剖学差异所致。
