Kapoor D A, Wasserman N F, Zhang G, Reddy P K
Department of Urologic Surgery, Minneapolis VA Medical Center, Minnesota.
Urology. 1993 Jun;41(6):594-7. doi: 10.1016/0090-4295(93)90114-p.
Transrectal ultrasound was performed on 15 men with clinical suspicion of local disease after radical retropubic prostatectomy. Clinical suspicion was defined as an elevation in serial serum prostate-specific antigen (PSA, above 0.4 ng/mL, Tandem-R + Assay) and/or palpable mass in the rectal vault. Post-radical prostatectomy ultrasound was normal if there was smooth tapering of the bladder neck to the urethra with no foci of variable echogenicity, and suspicious if any hyper- or hypo-echoic foci were present or if a mass was detected. Thirteen of 15 ultrasounds (87%) were described as suspicious while 2 of 15 (13%) were described as normal. Only 6 of 13 patients (46%) with suspicious findings on ultrasound had biopsy-proved carcinoma. Both patients with normal findings on post-radical prostatectomy ultrasound had biopsy-proved cancer. Transrectal ultrasound of the prostatic fossa when used independently is of no value in the diagnosis of local disease after radical prostatectomy. Transrectal ultrasound may help to direct systematic biopsies of the prostatic fossa in those patients in whom local disease is suspected on the basis of elevated serum PSA and/or a mass found on rectal examination.
对15名耻骨后前列腺癌根治术后临床上怀疑有局部疾病的男性患者进行了经直肠超声检查。临床怀疑的定义为连续血清前列腺特异性抗原（PSA，采用Tandem - R +检测法，高于0.4 ng/mL）升高和/或直肠腔内可触及肿块。如果膀胱颈至尿道呈平滑逐渐变细且无回声不均匀区域，则前列腺癌根治术后超声检查结果正常；如果存在任何高回声或低回声区域或检测到肿块，则结果可疑。15次超声检查中有13次（87%）被描述为可疑，而15次中有2次（13%）被描述为正常。在超声检查结果可疑的13名患者中，只有6名（46%）经活检证实为癌。前列腺癌根治术后超声检查结果正常的两名患者经活检也证实患有癌症。经直肠超声单独用于前列腺窝检查对前列腺癌根治术后局部疾病的诊断无价值。对于那些基于血清PSA升高和/或直肠指检发现肿块而怀疑有局部疾病的患者，经直肠超声可能有助于指导对前列腺窝进行系统性活检。
