The Study Of Transrectal Doppler Tenchnology In Diagnosis Of Benign Prostate Hypertrophy And Prostate Cancer

Objective: To study benign prostate hypertrophy and prostate cancer with transrectal color Doppler flow imaging (CDFI), pulsed wave Doppler(PW), color power angiography (CPA) and three-dimensional color power angiography (3D-CPA). the blood supply and hemodynamic parameters of normal prostates, benign prostate hypertrophys and prostate cancers were recorded. Mean color vessel density (MCVD) generated from CPA and Vascularity index (VI) generated from 3D-CPA were calculated. The aims were to analyze the characteristics of blood supply and hemodynamics in benign prostate hypertrophys and prostate cancers, explore the feasibility of CPA and 3D-CPA in detecting and quantitating tumor vessels, evaluate their clinical value in diagnosis, different diagnosis, the choice of operation methods and the assessment of treatment effect.Methods: In this study, 22 cases prostate cancers and 60 cases benign prostate hypertrophy were examined with CDFI, PW, CPA and 3D-CPA. Additionally 30 volunteers were examined with CDFI and PW as normal control. At first, the size, profile, location, the proportion of inner-gland and out-gland, relationship with surrounding and status of lymph node metastasis were recorded with B-mode ultrasound. Second, the blood flows in prostate were displayed with CDFI and graded according to the blood flow distribution and degree of blood supply richness. The optional PW spectra were acquired with sample volume 2㎜, angle between the sample line and blood flow less than 30. The peak systolic velocity (PSV), resistant index(RI) were measured and their maximum were recorded. Third, the blood flows in prostate were displayed with CPA and graded according to the blood flow distribution and degree of blood supply richness. The mean color vessels density (MCVD) was calculated using AutoCAD2004 software. 3D-CPA of the prostate vasculrity were reconstructucted in optimal serial CPA condition. All the best image of CDFI, CPA PW and 3D-CPA were captured and stored to the computer for later quantitative analysis. According to the staging criterion established on the American Urology Conference, the 22 prostate cancers were categorized into clinic A-D stages: 4 cases of stage A, 6 cases of stage B, 9 cases of stage C, 3 cases of stages D. All data were analyzed statistically. Results: (1) CDFI reveals a marked increase in blood flow of BPH and prostate cancer. In BPH, the flow signals mostly occurred in the inner or central gland, and it was symmetric without an obvious focus. In prostate cancer, it was depicted with obviously abnormal flow within and around the cancer lesion or hypo-echoic nodule. The blood supply of prostate were categorized into CDFI 0~4grade, In 30 normal prostate, 19 cases of grade 0, 11 cases of grade 1; In 60 benign prostate hypertrophy, 6 cases of grade 0, 19 cases of grade 1, 33 cases of grade 2, 2cases of grade 3, the proportion of beyond grade 2 and grade 2 are 55%; In 22 prostate cancer, 5cases of grade 1, 16 cases of grade 2, 1 cases of grade 3, the proportion of beyond grade 2 and grade 2 are 77%. There was significant difference among the normal, the benign prostate hypertrophy and the prostate cancer(p<0.01). (2)The average values of RI and PSV of the normal group, the benign prostate hypertrophy group and the prostate cancer group were 0.56±0.05, 0.67±0.09, 0.82±0.11 and 13.9㎝/, 20.3㎝/s, 28.8㎝/s respectively. The PSV and RI in the benign prostate hypertrophy was significant higher than in the normal, The PSV and RI in the prostate cancer was significant higher than in the prostate hypertrophy(p<0.01). (3) The blood supply of prostate were categorized into CPA 0~3 grade, In 60 benign prostate hypertrophy, 5 cases of grade 0, 16 cases of grade 1, 34 cases of grade 2, 5 cases of grade 3, the proportion of beyond grade 2 and grade 2 are 65%. In 22 prostate cancer, 3 cases if grade 1, 16 cases of stage 2, 3 cases of stage 3, the proportion of beyond grade 2 and grade 2 are 65%, The MCVD of the four CPA grades was 0.1113±0.0097,0.2407±0.0...