Kanao Kent, Kikuchi Eiji, Nakashima Jun, Horiguchi Yutaka, Nakagawa Ken, Oya Mototsugu, Ohigashi Takashi, Marumo Ken, Murai Masaru
Department of Urology, Keio University School of Medicine, Tokyo, Japan.
Int J Urol. 2004 Dec;11(12):1087-91. doi: 10.1111/j.1442-2042.2004.00950.x.
The clinical application of volume estimation by 3-D ultrasound has recently gained much attention. However, there have been no reports evaluating the prostate volume by 3-D transrectal ultrasound (TRUS) before transurethral resection of the prostate (TURP). The purpose of the present study was to evaluate the value of 3-D TRUS for prediction of prostate morphology and resected weight before TURP and to investigate whether 3-D TRUS is a more useful examination than 2D TRUS in patients with benign prostatic hyperplasia (BPH).
Transurethral resection of the prostate was performed in 23 patients with BPH. We evaluated the prostate morphology and measured both the volumes of the whole prostate and the transition zone using 2-D and 3-D TRUS, respectively. The actual resected weight was recorded and compared with the volume of the whole prostate and that of the transition zone measured by 2D and 3-D TRUS.
The volume of the transition zone measured by 3-D TRUS correlated most strongly with the resected weight (r = 0.84). A large median lobe was seen in three patients in whom the transition zone volume measured by 2-D TRUS was considerably larger than the resected weight. However, overestimation in the three patients decreased by the use of 3-D TRUS.
It was concluded that 3-D TRUS was equal or superior to 2-D TRUS in prediction of the resected weight and 3-D TRUS offers better information as a diagnostic tool before TURP.
三维超声容积估计的临床应用近来备受关注。然而,尚无经尿道前列腺切除术(TURP)前通过三维经直肠超声(TRUS)评估前列腺体积的相关报道。本研究的目的是评估三维TRUS在TURP前预测前列腺形态和切除重量的价值,并探讨在良性前列腺增生(BPH)患者中,三维TRUS是否比二维TRUS更具诊断价值。
对23例BPH患者实施经尿道前列腺切除术。我们分别使用二维和三维TRUS评估前列腺形态,并测量整个前列腺及移行区的体积。记录实际切除重量,并与二维和三维TRUS测量的整个前列腺及移行区体积进行比较。
三维TRUS测量的移行区体积与切除重量的相关性最强(r = 0.84)。二维TRUS测量的移行区体积明显大于切除重量的3例患者中可见较大的中叶。然而,这3例患者使用三维TRUS后高估情况有所减少。
得出结论,在预测切除重量方面,三维TRUS等同于或优于二维TRUS,且三维TRUS作为TURP前的诊断工具能提供更好的信息。