Wu Fan, Zhang Ming Bo, Wang Yi Ru, Yang Ying Ying, Li Ying Ying
Department of Ultrasound,First Medical Center,Chinese PLA General Hospital,Beijing 100853,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020 Feb 28;42(1):73-79. doi: 10.3881/j.issn.1000-503X.11163.
To explore the value of trans-rectal shear wave elastic mode combined with elastic modulus in the diagnosis of prostate cancer and establish a new method for the evaluation of prostate with trans-rectal shear wave elastography(SWE). The typical findings of trans-rectal ultrasound(US)and SWE in 79 patients with prostate cancer(=41)and benign prostatic hyperplasia(BPH)(=38)confirmed by surgery or US-guided biopsy were analyzed retrospectively.Their diagnostic value were evaluated with the pathological results as the golden standards. Three or more malignant features detected by conventional trans-rectal US( =42.5,<0.001)and asymmetrical SWE mode( =54.2,<0.001)showed statistically significant difference in prostate cancer and BPH groups.The elastic modulus of Emean and Emax in the prostate cancer group were(92.8±21.5)and(114.2±29.8)kPa,which were significantly higher than those in the BPH group [(56.7±14.0)(=-8.8,<0.001)and(68.4±17.2)kPa(=-8.3,<0.001)].The receiver-operating characteristic(ROC)curve with Logistic regression showed that the elastic model combined elastic modulus had the largest area under ROC curve and the highest diagnosis efficiency of prostate cancer,with the cutoff value of 0.45.The diagnosis sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of the combination were 95.1%,89.5%,90.7%,94.4%,and 92.4%,respectively. Combination of SWE mode and elastic modulus is more valuable than elastic modulus alone in the diagnosis of prostate cancer.
探讨经直肠剪切波弹性成像模式联合弹性模量在前列腺癌诊断中的价值,建立经直肠剪切波弹性成像(SWE)评估前列腺的新方法。回顾性分析79例经手术或超声引导下活检确诊为前列腺癌(n = 41)和良性前列腺增生(BPH,n = 38)患者的经直肠超声(US)及SWE典型表现。以病理结果为金标准评估其诊断价值。常规经直肠超声检测到3个或更多恶性特征(n = 42.5,P < 0.001)和不对称SWE模式(n = 54.2,P < 0.001)在前列腺癌组和BPH组中差异有统计学意义。前列腺癌组Emean和Emax弹性模量分别为(92.8±21.5)kPa和(114.2±29.8)kPa,显著高于BPH组[(56.7±14.0)kPa(t = -8.8,P < 0.001)和(68.4±17.2)kPa(t = -8.3,P < 0.001)]。Logistic回归绘制的受试者工作特征(ROC)曲线显示,弹性模型联合弹性模量的ROC曲线下面积最大,前列腺癌诊断效率最高,截断值为0.45。联合诊断的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为95.1%、89.5%、90.7%、94.4%和92.4%。SWE模式与弹性模量联合在前列腺癌诊断中比单独弹性模量更有价值。