Department of Ultrasound, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
Eur J Radiol. 2012 May;81(5):857-62. doi: 10.1016/j.ejrad.2011.02.037. Epub 2011 Mar 9.
This study was to assess the diagnostic value of strain index (SI) for transrectal real-time tissue elastography (TRTE) on differentiating malignant from benign lesions in the prostate peripheral zone.
83 patients suspected of having prostate cancer (PCa) underwent transrectal ultrasonography (TRUS) and TRTE examinations. The lesions in the prostate peripheral zone detected by TRTE were set as the regions of interest (ROI) for strain ratio (SR) measurement (SRA). The moderate texture tissues without lesion were set as the reference ROI for SR measurement (SRB). Then, SI (SRB/SRA) of total lesions (ASI) and local lesion (PSI) were calculated, and the diagnostic values of ASI and PSI on differentiating benign from malignant lesions were assessed respectively.
The range of PSI was 2.23-67.21 (29.97 ± 15.58) in malignant tumors and 0. 4-43.6 (7.79 ± 8.75) in benign lesions (AUC=0.90), while the range of ASI was 2.84-47.9 (8.38 ± 12.20) in malignant tumors and 0.4 -2.79 (5.85 ± 7.29) in benign lesions (AUC=0.62). There was significant difference of PSI values between the benign and malignant lesions (P<0.01). At the cutoff value of 17.44, PSI yielded the highest sensitivity (74.5%) and specificity (83.3%) for discriminating PCa from benign lesions. The capability of PSI in the diagnosis of PCa improved with the increase of Gleason scores.
PSI is one of the elasticity parameters obtained easily by TRTE, it can provide more information in the differentiation of prostate peripheral zone lesions.
本研究旨在评估应变指数（SI）在经直肠实时组织弹性成像（TRTE）中对前列腺外周带良恶性病变的诊断价值。
83 例疑似前列腺癌（PCa）患者接受经直肠超声（TRUS）和 TRTE 检查。TRTE 检测到的前列腺外周带病变设为应变比（SR）测量的感兴趣区（ROI）（SRA）。无病变的中等纹理组织设为 SR 测量的参考 ROI（SRB）。然后计算总病变（ASI）和局部病变（PSI）的 SI（SRB/SRA），并分别评估 ASI 和 PSI 对鉴别良恶性病变的诊断价值。
恶性肿瘤 PSI 范围为 2.23-67.21（29.97±15.58），良性病变 PSI 范围为 0.4-43.6（7.79±8.75）（AUC=0.90），恶性肿瘤 ASI 范围为 2.84-47.9（8.38±12.20），良性病变 ASI 范围为 0.4-2.79（5.85±7.29）（AUC=0.62）。良性和恶性病变的 PSI 值有显著差异（P<0.01）。在 17.44 的截断值下，PSI 对鉴别 PCa 与良性病变的敏感性（74.5%）和特异性（83.3%）最高。PSI 对 PCa 的诊断能力随 Gleason 评分的增加而提高。
PSI 是 TRTE 获得的弹性参数之一，它可以提供更多的前列腺外周带病变鉴别信息。
