Griffiths G J, Clements R, Jones D R, Roberts E E, Peeling W B, Evans K T
Clin Radiol. 1987 May;38(3):219-27. doi: 10.1016/s0009-9260(87)80048-x.
An analysis of the ultrasound appearances of the prostate with its capsule and periprostatic structures was performed in 221 patients with a histologically confirmed diagnosis of prostatic cancer. The cancers were histologically graded into well, moderate and poorly differentiated adenocarcinoma and transitional cell carcinoma. The results of this study indicate that an ill-defined hypoechoic area is the commonest appearance of prostatic cancer; this was seen in 96% of our 221 patients. The cancers were staged by ultrasound into confined (T0, T1, T2) and unconfined (T3) cancers. A breach of the capsule was seen in 55% of cases. In this unconfined group all cancers were hypoechoic in comparison with 92% in the confined group. In the confined cancer group the areas of abnormal echogenicity were present in more than one prostatic quadrant in 76%. Mostly commonly two prostatic quadrants were affected. The abnormal echogenicity was noted in the posterior quadrants of the prostate more commonly (58%) than in the anterior quadrants. The prostate gland appeared round in 67%, semicircular in 25% and crescentic in 8%. The gland was symmetrical in 68%. The prostatic capsule appeared regular in 86% of patients with a confined cancer. In 70% of cases of extensive but confined cancer there was loss of demarcation between the central and peripheral zones of the gland. The unconfined cancer group all had a breach of the capsule and all glands were heterogeneous due to hypoechoic areas. The breach affected more than one quadrant in 81% and most commonly the capsular breach involved two prostatic quadrants. An anterior breach of the capsule was noted much more frequently than a posterior breach. Forty-four per cent of cases had three or four quadrants of the gland involved. In 3% of cases of proven prostatic cancer no definite ultrasound abnormality could be detected. Calcification was seen within the gland in association with the cancer in 63% with approximately equal frequency in confined and unconfined disease. The seminal vesicles showed definite evidence of infiltration in 10%. Both seminal vesicles were seen in 61% and thought to be normal. In 8% only one was seen. Failure to demonstrate either seminal vesicle occurred in 21%. There was no correlation between the ultrasound appearances of prostatic cancer and the histological grading of the tumour.
对221例经组织学确诊为前列腺癌的患者的前列腺及其包膜和前列腺周围结构的超声表现进行了分析。这些癌症在组织学上被分为高分化、中分化和低分化腺癌以及移行细胞癌。本研究结果表明，边界不清的低回声区是前列腺癌最常见的表现；在我们的221例患者中有96%出现这种情况。通过超声将癌症分期为局限型（T0、T1、T2）和非局限型（T3）癌症。55%的病例可见包膜破裂。在这个非局限型组中，所有癌症均为低回声，而局限型组中这一比例为92%。在局限型癌症组中，76%的病例异常回声区出现在一个以上的前列腺象限。最常见的是两个前列腺象限受累。前列腺后象限出现异常回声比前象限更常见（58%）。前列腺呈圆形的占67%，半圆形的占25%，新月形的占8%。腺体对称的占68%。局限型癌症患者中86%的前列腺包膜外观正常。在70%的广泛但局限型癌症病例中，腺体中央区和外周区之间的界限消失。非局限型癌症组所有病例均有包膜破裂，且由于低回声区所有腺体均不均匀。81%的包膜破裂累及一个以上象限，最常见的是包膜破裂累及两个前列腺象限。包膜前破裂比后破裂更常见。44%的病例腺体的三个或四个象限受累。在3%的经证实的前列腺癌病例中，未检测到明确的超声异常。63%的病例在腺体内可见与癌症相关的钙化，局限型和非局限型疾病中的出现频率大致相等。精囊有明确浸润证据的占10%。61%的病例可见双侧精囊，且认为正常。8%的病例仅见一侧精囊。21%的病例双侧精囊均未显示。前列腺癌的超声表现与肿瘤的组织学分级之间无相关性。
