Interventional Radiology Department, Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
Interventional Radiology Department, Sírio-Libanês Hospital, Adma Jafet Street, 115 Bela Vista, São Paulo, SP, 01308-050, Brazil.
Cardiovasc Intervent Radiol. 2019 Jul;42(7):1001-1007. doi: 10.1007/s00270-019-02220-x. Epub 2019 Apr 16.
To determine the effects of prostatic artery embolization (PAE) on prostatic elasticity as assessed by Ultrasound Elastography (US-E), as well as to describe the feasibility and role of US-E as a novel tool in both pre- and post-PAE evaluation.
This is a prospective, single-center investigation that included eight patients undergoing PAE for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH). Baseline and 3-month follow-up evaluations were performed and included prostate-specific antigen (PSA), uroflowmetry, pelvic magnetic resonance imaging and clinical assessment using the International Prostate Symptom Score (IPSS) questionnaire and the IPSS-Quality of life (QoL) item. US-E with measurement of the prostatic Elastic Modulus (EM) was performed before PAE and at 1-month follow-up.
After PAE, US-E showed a significant reduction of prostatic EM as assessed in kPa (33.14 vs. 47.24, - 29.8%, p = 0.002) and in m/s (3.75 vs. 4.63, - 19.0%, p < 0.001). Also, the transitional/peripheral zone ratio was significantly reduced by 45.36% (0.53 vs. 0.97, p < 0.05). All eight patients presented with significant LUTS improvement after PAE (p < 0.05 for IPSS, QoL, prostate volume, peak urinary flow rate and PSA).
Findings described in this study suggest that PAE significantly reduces prostatic EM, leading to a positive effect on BPH dynamic component related to prostatic elasticity. Also, it features US-E as an additional tool for pre- and post-PAE evaluation, describing a novel indication for this technology.
通过超声弹性成像（US-E）评估前列腺动脉栓塞术（PAE）对前列腺弹性的影响，并描述 US-E 在 PAE 前后评估中的可行性和作用，作为一种新的工具。
这是一项前瞻性、单中心研究，纳入了 8 名因良性前列腺增生（BPH）而下尿路症状（LUTS）接受 PAE 治疗的患者。进行了基线和 3 个月的随访评估，包括前列腺特异性抗原（PSA）、尿流率、盆腔磁共振成像和使用国际前列腺症状评分（IPSS）问卷和 IPSS 生活质量（QoL）项目进行的临床评估。在 PAE 前和 1 个月随访时进行 US-E 并测量前列腺弹性模量（EM）。
PAE 后，kPa 下前列腺 EM 明显降低（33.14 对 47.24，-29.8%，p=0.002），m/s 下 EM 也明显降低（3.75 对 4.63，-19.0%，p<0.001）。此外，移行区/外周带比值降低了 45.36%（0.53 对 0.97，p<0.05）。8 名患者在 PAE 后均出现明显的 LUTS 改善（IPSS、QoL、前列腺体积、最大尿流率和 PSA 的 p 值均<0.05）。
本研究结果表明，PAE 可显著降低前列腺 EM，从而对与前列腺弹性相关的 BPH 动力学成分产生积极影响。此外，它还将 US-E 作为 PAE 前后评估的附加工具，为该技术提供了新的适应证。
