多模态超声鉴别前列腺良恶性病变的诊断价值

赵云鹏; 马振县; 王臻; 聂芳

doi:10.19732/j.cnki.2096-6210.2023.06.007

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多模态超声鉴别前列腺良恶性病变的诊断价值

论著 | 更新时间：2025-12-15

- 多模态超声鉴别前列腺良恶性病变的诊断价值
- Diagnostic value of benign and malignant prostate lesions of multimodal ultrasonography
- 肿瘤影像学 2023年32卷第6期页码：525-530
- 作者机构：
- 作者简介：
- 基金信息：
  
  甘肃省科技计划项目重点研发计划（21YF5FA122）
- DOI：10.19732/j.cnki.2096-6210.2023.06.007
  中图分类号：
- 网络出版：2024-01-05，
  
  纸质出版：2024-01-05
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赵云鹏,马振县,王臻,等. 多模态超声鉴别前列腺良恶性病变的诊断价值[J]. 肿瘤影像学, 2023, 32(6): 525-530 https://doi.

org/10.19732/j.cnki.2096-6210.2023.06.007
赵云鹏,马振县,王臻,等. 多模态超声鉴别前列腺良恶性病变的诊断价值[J]. 肿瘤影像学, 2023, 32(6): 525-530 https://doi. DOI： 10.19732/j.cnki.2096-6210.2023.06.007.

org/10.19732/j.cnki.2096-6210.2023.06.007 DOI：

摘要

目的：

探讨多模态超声鉴别前列腺良恶性病变的诊断价值。

方法：

对2020年6月—2023年3月兰州大学第二医院228例可疑前列腺癌患者的临床、灰阶超声、彩色多普勒超声、弹性成像及超声造影特征进行单因素分析及多因素logistic回归分析，并绘制受试者工作特征（receiver operating characteristic，ROC）曲线，评判各超声特征单一应用及联合应用对鉴别前列腺良恶性病变的诊断价值。

结果：

单因素分析显示，年龄、前列腺体积、总前列腺特异性抗原（total prostate-specific antigen，tPSA）、游离前列腺特异性抗原（free prostate-specific antigen，fPSA）、前列腺特异性抗原密度（prostate-specific antigen density，PSAD）、病灶回声、有钙化、内外腺分界不清晰、外腺实质回声不均匀、包膜不光滑完整、多普勒基线评分法＞2、应变弹性5分法＞2、始增时间、始增速度、峰值强度、廓清时间、廓清速度差异均有统计学意义。多因素logistic分析显示，PSAD、病灶包膜不光滑完整、应变弹性5分法＞2分、快进及高增强为前列腺癌的独立预测因子，曲线下面积（area under curve，AUC）分别为0.881、0.627、0.743、0.701及0.620，联合应用的AUC为0.936。

结论：

PSAD、病灶包膜不光滑完整、前列腺超声应变弹性5分法＞2分、超声造影提示造影剂快进及高增强对前列腺良恶性病灶具有较高的诊断效能，多种超声模态同时应用可以提高对前列腺癌的诊断效能。

Abstract

Objective:

To investigate the diagnostic value of multimodal ultrasound of benign and malignant prostate lesions.

Methods:

The clinical

grayscale ultrasound

color Doppler ultrasound

elastography and contrast-enhanced ultrasound features of 228 patients with suspected prostate cancer in The Second Hospital of

Lanzhou University from June 2020 to March 2023 were analyzed

and they were divided into benign group (114 cases) and malignant group (114 cases) according to the pathological results of puncture. Univariate analysis and multivariate logistic regression analysis were performed on each modal ultrasound feature

independent predictors were screened

the receiver operating characteristic (ROC) curve was drawn

and the diagnostic efficacy of single application and combination application of each ultrasound feature in the identification of benign and malignant prostate lesions was evaluated.

Results:

Univariate analysis showed that there were significant differences in age

volume

total prostate-specific antigen (tPSA)

free prostate-specific antigen (fPSA)

prostate-specific antigen density (PSAD)

echo of the lesion

calcification

unclear boundary between internal and external glands

heterogeneous echo of external glands

unsmooth and intact capsule

Doppler baseline score ＞2

strain elasticity 5 score ＞2

initial increase time

initial increase speed

peak enhancement

clearance time and clearance speed. Multivariate logistic analysis showed that PSAD

nonsmooth and intact capsule

strain elasticity 5 score ＞2

fast advance and high contrast enhancement were independent predictors of benign and malignant prostate lesions

the area under curve (AUC) was 0.881

0.627

0.743

0.701 and 0.620

respectively

and 0.936 for combined application.

Conclusion:

PSAD

the unsmooth and intact capsule of the lesion

the 5-point method of ultrasonic strain elasticity of the prostate ＞2 points

contrast-enhanced ultrasound indicating fast progression of the lesion and high enhancement are effective in the diagnosis of benign and malignant lesions of the prostate

multi-mode ultrasound can improve the diagnostic efficiency of prostate cancer.

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