声触诊组织定量技术和直肠指诊对前列腺病变的诊断价值对比研究

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摘要目的：声触诊组织定量技术（VTTQ）是一种检测组织硬度的新技术。本研究的目的是比较VTTQ和直肠指诊（DRE）之间对于前列腺癌（PCa）和良性前列腺增生（BPH）的效能。方法：VTTQ用于检测60例BPH和疑似PCa患者，每一个病灶通过声辐射脉冲（ARFI）激发并测量相应病变的剪切波速（SWV）值。测值与病理结果对照，对VTTQ和DRE鉴别PCa和BPH之间的诊断效能进行比较。结果：PCa和BPH组织的SWV值（m?蛐s）明显大于正常前列腺组织（2.97±0.42，2.61±0.47，2.46±0.52），差异有显著性。在ROC曲线中，以SWV>2.87 m?蛐s为诊断标准，VTTQ诊断前列腺良恶性病变的曲线下面积（AUC）为0.78，而DRE是0.67。VTTQ诊断PCa的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为80.0%，66.7%，74.3%，72.0%，79.2%，而DRE分别为57.5%，52.3%，62.5%，57.0%，62.1%。结论：VTTQ可以有效地检测前列腺结节病变的硬度，在鉴别PCa和BPH方面比DRE具有更高的诊断效能。

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	龚继军
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	张雁
	陶令之

关键词 ：前列腺肿瘤, 前列腺增生, 超声检查, 多普勒, 彩色

Abstract：Objective: Virtual touch tissue quantification(VTTQ) is a new, promising technique for detecting the stiffness of tissues. The aim of this study is to compare the performance of VTTQ and digital rectal examination(DRE) in discrimination between prostate cancer(PCa) and benign prostatic hyperplasia(BPH). Methods: VTTQ was performed in 60 patients with suspected BPH and PCa before the prostate histopathologic examination. The shear wave velocity(SWV) at each nodular lesion was quantified by implementing an acoustic radiation force impulse(ARFI). The performance of VTTQ and DRE in discrimination between PCa and BPH was compared by the pathology. Results: The SWV values(m/s) were significantly greater in PCa and BPH than in normal prostate(2.97±0.42, 2.61±0.47 and 2.46±0.52). The area under the receiver operating characteristic curve(AUC) for VTTQ(SWV>2.87 m/s) to differentiate prostate nodules as benign hyperplasia or malignancy was 0.78, while it was 0.67 for DRE. The diagnostic sensitivity, specificity, PPV, NPV and accuracy were 80.0%, 66.7%, 74.3%, 72.0%, 79.2%, respectively for VTTQ(SWV>2.87 m/s), whereas they were 57.5%, 52.3%, 62.5%, 57.0%, 62.1% respectively for DRE. Conclusion: VTTQ can effectively detect the stiffness of prostate nodular lesions, which has a significantly higher performance than DRE in discrimination between PCa and BPH.

Key words： Prostatic neoplasms Prostatic hyperplasia Ultrasonography, Doppler, color

收稿日期: 2016-05-06

PACS:	Ｒ737.25
	Ｒ697.3
	Ｒ445.1

基金资助:本课题受深圳市科技计划项目资助（项目编号：JCYJ20140415162338776）。

通讯作者: 龚继军，北京大学深圳医院超声影像科，518036。E-mail：pkuszh@yeah.net

作者简介: 龚继军（1979-），男，湖南武冈人，副主任医师。E-mail：pkuszh@yeah.net

引用本文:

龚继军，刘俐，薛敏，石宇，吴国儒，张雁，陶令之. 声触诊组织定量技术和直肠指诊对前列腺病变的诊断价值对比研究[J]. 中国临床医学影像杂志, 2017, 28(2): 120-122.
GONG Ji-jun, LIU Li, XUE Min, SHI Yu, WU Guo-ru, ZHANG Yan, TAO Ling-zhi. A comparison of virtual touch tissue quantification and digital rectal examination for prostatic lesions. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(2): 120-122.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I2/120

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