Kelly I M, Lees W R, Rickards D
Department of Imaging, Middlesex Hospital, London, England.
Radiology. 1993 Oct;189(1):153-6. doi: 10.1148/radiology.189.1.7690489.
To determine the role of color Doppler imaging (CDI) in diagnosis of prostate cancer.
Transrectal ultrasound (TRUS) and CDI were performed in 456 patients with possible prostate cancer. Of these patients, 158 underwent prostate biopsy, and these formed the study group.
The frequency of malignancy was 47% (75 of 158). Of 136 TRUS-positive cases, 72 were malignant and 64 benign. Of 84 CDI-positive cases, 65 were malignant and 19 benign (chi 2 = 12.18, P < .001). Thirteen percent of histopathologically proved cases (10 of 75) were normal at CDI. TRUS alone had a sensitivity of 96% and a positive predictive value (PPV) of 0.53. The addition of CDI increased the PPV to 0.77 but reduced the sensitivity to 87%. In only one case out of 158 did CDI suggest the diagnosis of malignancy independently of TRUS.
CDI improves the PPV of TRUS but appears to have little additional value over TRUS alone in diagnosis of prostate cancer.
确定彩色多普勒成像(CDI)在前列腺癌诊断中的作用。
对456例疑似前列腺癌患者进行经直肠超声检查(TRUS)和CDI检查。其中158例患者接受了前列腺活检,这些患者组成了研究组。
恶性肿瘤发生率为47%(158例中的75例)。在136例TRUS阳性病例中,72例为恶性,64例为良性。在84例CDI阳性病例中,65例为恶性,19例为良性(χ² = 12.18,P <.001)。经组织病理学证实的病例中有13%(75例中的10例)在CDI检查时结果正常。单独使用TRUS时,敏感性为96%,阳性预测值(PPV)为0.53。添加CDI后,PPV提高到0.77,但敏感性降至87%。在158例患者中,只有1例CDI独立于TRUS提示恶性肿瘤诊断。
CDI提高了TRUS的PPV,但在前列腺癌诊断中,其相对于单独使用TRUS似乎没有太多额外价值。