Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
J Endourol. 2010 May;24(5):685-91. doi: 10.1089/end.2009.0640.
To describe the current and new developments in transrectal ultrasound (US) imaging of the prostate.
Grayscale imaging of the prostate is the standard method for diagnostic evaluation and biopsy guidance. Color Doppler (CD) imaging, including CD and power Doppler US, allows for detection of macrovascularity and may therefore be helpful for assessment of prostatic blood flow. The use of US microbubbles for CD imaging and new contrast-specific techniques enable assessment of prostate microvascularity associated with prostate cancer (PCa). Recently, real-time elastography has been introduced to improve detection of cancer based upon changes in tissue stiffness.
Contrast-enhanced CD imaging has shown to enable PCa detection by performing targeted biopsies into suspicious areas. Comparisons between systematic and contrast-enhanced targeted biopsies have shown that the targeted approach detects more cancers and cancers with higher Gleason scores with a reduced number of biopsy cores. New microbubble-specific US techniques can improve sensitivity and specificity of US imaging for PCa detection. Real-time elastography has been demonstrated to be useful for the detection of PCa, and may further improve PCa staging.
The new US techniques seem to have the potential to improve PCa detection, and also PCa grading and staging. As these diagnostic methods improve, the ultimate hope is to eliminate biopsy in patients without cancer.
描述经直肠超声（TRUS）前列腺成像的现状和新进展。
灰阶成像仍是诊断评估和活检引导的标准方法。彩色多普勒（CD）成像，包括 CD 和能量多普勒超声，可用于检测大血管，因此可能有助于评估前列腺血流。CD 成像中应用超声微泡以及新的对比特异性技术可评估与前列腺癌（PCa）相关的前列腺微血管。最近，实时弹性成像已被引入，以提高基于组织硬度变化的癌症检测能力。
增强型 CD 成像通过对可疑区域进行靶向活检，显示出可提高 PCa 检测能力。系统和增强型靶向活检的比较表明，靶向方法可检测到更多的癌症，且癌症的 Gleason 评分更高，同时活检针数减少。新型超声微泡特异性技术可提高 PCa 检测的敏感性和特异性。实时弹性成像已被证明对 PCa 的检测有用，可能进一步改善 PCa 的分期。
这些新的超声技术似乎有可能提高 PCa 的检测能力，还可能改善 PCa 的分级和分期。随着这些诊断方法的改进，最终的目标是消除无癌症患者的活检。
