经直肠彩色多普勒超声检查对前列腺癌的诊断与鉴别诊断价值

目的采用经直肠腔内彩色多普勒超声对前列腺增生症及前列腺癌进行检测，通过其血流动力学特点，反映前列腺增生症与前列腺癌血供情况，评价对前列腺增生症与前列腺癌诊断与鉴别诊断的意义。方法应用经直肠彩超对50例良性前列腺增生症（BPH）和30例前列腺癌（Pca）进行检测，测量前列腺大小，观察尿道前列腺动脉，对前列腺内动脉血流情况进行分级，测量阻力指数（ResistanceIndex。RI）。结果前列腺增生症（BPH）组体积明显增大，多为强回声结节，主要分布在内腺。前列腺癌（Pea）组体积增大，多为低回声结节。主要分布在外腺且双侧叶不对称。前列腺癌血流分级、阻力指数（RI）均高于前列腺增生。两组各项指标间差异有统计学意义（P〈0．01）。前列腺癌的血流丰富，阻力指数RI〉0．75。结论经直肠彩色多普勒超声显示的血流分级及血流参数RI对前列腺增生和前列腺癌的诊断与鉴别诊断具有重要作用。

The Value of Transrectal Color Doppler Ultrasonography in Diagnosing and Differentiating Prostatic Carcinoma

Objective Transrectal color Doppler uhrasonography is used to detect benign prostatic hyperplasia （BPH） and prostatic carcinoma （Pca）. The clinical value of transrectal color Doppler ultrasonography in diagnosing and differentiating benign prostatic hyperplasia and prostatic carcinoma is evaluated by hemodynamic characteristics which reflect the blood supply of benign prostate hyperplasia and prostate cancer. Methods 50 benign prostate hyperplasia and 30 prostate carcinoma were detected to observe the prostatic＇volume and transurethrat prostatic artery, classify the artery flow in the prostate, measure the resistance index（RI） by tran- srectal color Doppler uhrasonography. Results The average volume of BPH group was enlarged manifestly and nodules mostly dis- tributed in inner gland were mainly hyperechoic. The average volume of Pca group was enlarged and nodules mostly distributed in outer gland were hypoechoic and the prostate gland was asymmetric bilateral sides. In Pca group, the flow classification and RI were markedly higher than those in BPH group, the differences were statistically significant（P〈0.01）. Pca had richful arterial blood supply and the resistance indexes were higher than 0.75. Conclusion Flow classification and parameters and RI showed by tran- srectal color Doppler ultrasonography play an important role in the diagnosis and differentiating of benign prostatic hyperplasia and prostatic carcinoma.