The value of contrast enhanced ultrasound in diagnosis of benign and malignant prostatic neoplasms / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the value of transrectal contrast enhanced ultrasound(TR-CEUS) in diagnosis of benign and malignant prostatic neoplasms.Methods Sixty patients with elevated level of serum prostate specific antigen and suspected prostate diseases were examined with transrectal uhrasound(TRUS), and TR-CEUS.The pattern and intensity of CEUS in these patients were observed;and the patients with nodules were examined with CEUS guided biopsy and sextant system biopsy after ultrasound imaging.Time-intensity curves (TIC) were drawn to calculate the parameters, and the difference between benign and malignant nodes was compared.Results All sixty prostate patients were confirmed by pathological examination.Thirty-seven patients belong to benign lesions, among them 15 patients with nodule lesion had total 20 nodules, while 22 cases had benign prostatic hyperplasia.In 23 cases of malignant lesions, 18 cases had centralized nodules and 5 cases showed diffuse pathologic changes.Benign nodes of inner gland showed a main pattern of homogenous enhancement and a clear node zone, whereas, malignant nodes displayed significant enhancement in peripheral tissue.The time to peak and accelerating time (ACT) of malignant nodes were shorter than those of benign nodes (P <0.05).There was no significance in arrival time (AT) between the two groups (P>0.05).The accordance rate of TR-CEUS in the differential diagnosis of benign and malignant prostatic lesions was higher than that of TRUS (P<0.05).In addition, the sensitivity, specificity and accurate rate of TR-CEUS were higher than those of TRUS, whereas, both misdiagnosis and missed diagnosis rate of TR-CEUS were lower than those of TRUS.Conclusions TR-CEUS has clinical value for early discovery of prostatic cancer and has higher application value to differentiate malignant from benign diseases.