Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Br J Radiol. 2012 Jun;85(1014):714-9. doi: 10.1259/bjr/68418881. Epub 2011 Jun 28.
The aim of this study was to evaluate the role of three-dimensional transrectal ultrasound in the diagnosis of prostate cancer.
A total of 112 patients with elevated serum prostate-specific antigen (PSA) or a positive digital rectal examination were evaluated using three-dimensional greyscale transrectal ultrasound (3D-GS TRUS) and three-dimensional power Doppler sonography (3D-PDS). Target biopsies were obtained together with 12 core systematic biopsies. Pathological results were correlated with the imaging data.
Cancers were detected in 269 biopsy sites from 41 patients. 229 sites of cancer were depicted by 3D-GS TRUS and 213 sites were depicted by 3D-PDS. 30 sites were missed by both 3D-GS TRUS and 3D-PDS. Abnormal prostate images depicted by 3D-GS TRUS and 3D-PDS were associated with lesions with a Gleason score of 6.9 or higher.
The detection rates of prostate cancer were significantly improved with 3D-GS TRUS and 3D-PDS on serum PSA levels >10 ng ml(-1) or 20 ng ml(-1). 3D-GS TRUS and 3D-PDS may improve the biopsy yield by determining appropriate sites for target and systematic biopsies. The abnormalities detected by 3D ultrasound were associated with moderate- and high-grade prostate cancers. However, based on the number of false-negative TRUS results, the use of systematic prostate biopsies should not be eliminated.
本研究旨在评估三维经直肠超声在前列腺癌诊断中的作用。
对 112 例血清前列腺特异性抗原（PSA）升高或直肠指诊阳性的患者进行三维灰阶经直肠超声（3D-GS TRUS）和三维能量多普勒超声（3D-PDS）检查。对所有患者进行靶向活检和 12 针系统活检。将病理结果与影像学数据进行比较。
在 41 例患者的 269 个活检部位中检测到癌灶。3D-GS TRUS 显示 229 个癌灶，3D-PDS 显示 213 个癌灶。3D-GS TRUS 和 3D-PDS 均漏诊 30 个部位。3D-GS TRUS 和 3D-PDS 显示的异常前列腺图像与 Gleason 评分≥6.9 的病变相关。
血清 PSA 水平>10ng/ml 或 20ng/ml 时，3D-GS TRUS 和 3D-PDS 可显著提高前列腺癌的检出率。3D-GS TRUS 和 3D-PDS 可通过确定靶向和系统活检的合适部位来提高活检的阳性率。3D 超声检测到的异常与中、高级别前列腺癌相关。然而，根据 TRUS 假阴性结果的数量，不应该取消系统前列腺活检。
