Department of Radiology, Eastern Clinical University Hospital, Riga Stradins University, Latvia.
Anticancer Res. 2011 Apr;31(4):1421-6.
The aim of our study was to evaluate the diagnostic value of contrast-enhanced ultrasonography (CEUS) in comparision to morphological examinations of radical prostatectomy specimens and to study factors limiting the visibility of malignant lesions.
Fifty patients with proven prostate cancer (PV) were examined transrectally using, grey-scale, power Doppler (PD) and CEUS (pulse-inversion mode, low mechanical index) shortly before prostatectomy. The results were compared with morphological findings. The influence of tumour size, localization and grade on tumour visibility was studied.
A total of 72 prostate cancer foci were found at pathologic evaluation. Grey-scale imaging demonstrated 34 (47.2%), power Doppler 37 (51.4%) and CEUS 44 (61.1%) of these foci. No lesion less than 1 cm in size was detected. Statistically significant correlation was established between the visibility of of tumour in CEUS and the size of a focus (r=0.610, p=0.001). Sensitivity of CEUS in detection of peripheral gland tumours was 63.3%, of lesions invading both peripheral and central gland 83.3%, and of centrally located tumours 27.8%. In comparision, sensitivity of grey-scale imaging was 53.3%, 70.8% and 5.6%, respectively. CEUS detected 35.5% of low-grade and 80% of intermediate-grade tumours; the corresponding results of grey-scale imaging were 16.1% and 70%, respectively. Statistically significant correlation was detected (r=0.459: p=0.001) between visualization capabilities of CEUS and the malignant grade of prostate cancer.
CEUS improves prostate cancer detection. Sensitivity of CEUS is lower in cases of small low-grade tumours, centrally located lesions and large infiltrating prostate tumours.
本研究旨在评估对比增强超声（CEUS）在与根治性前列腺切除术标本的形态学检查相比时的诊断价值，并研究限制恶性病变可见性的因素。
50 例经证实患有前列腺癌（PV）的患者在前列腺切除术之前经直肠接受了灰阶、功率多普勒（PD）和 CEUS（反转脉冲模式，低机械指数）检查。结果与形态学发现进行了比较。研究了肿瘤大小、位置和分级对肿瘤可见性的影响。
在病理评估中发现了总共 72 个前列腺癌病灶。灰阶成像显示 34 个（47.2%），功率多普勒显示 37 个（51.4%），CEUS 显示 44 个（61.1%）。没有发现小于 1 厘米大小的病变。在 CEUS 中肿瘤可见性与焦点大小之间建立了统计学上显著的相关性（r=0.610，p=0.001）。CEUS 检测外周腺体肿瘤的敏感性为 63.3%，检测同时侵犯外周和中央腺体的病变的敏感性为 83.3%，检测中央部位肿瘤的敏感性为 27.8%。相比之下，灰阶成像的敏感性分别为 53.3%、70.8%和 5.6%。CEUS 检测到 35.5%的低分级肿瘤和 80%的中分级肿瘤；灰阶成像的相应结果分别为 16.1%和 70%。检测到 CEUS 的可视化能力与前列腺癌的恶性分级之间存在统计学显著相关性（r=0.459：p=0.001）。
CEUS 提高了前列腺癌的检出率。CEUS 的敏感性在小的低分级肿瘤、中央部位病变和大的浸润性前列腺肿瘤中较低。
