Application Of Contrast-enhanced Transrectal Ultrasound In The Diagnosis Of Prostate Cancer

Objective:To explore the clinical value of contrast-enhanced transrectal ultrasound in the diagnosis of prostate cancer.Methods: The clinical data of 96 patients with suspected PCa admitted to the Second Hospital of Hebei Medical University from December 2019 to January 2021 were retrospectively analyzed.After admission,all patients underwent relevant examinations such as prostate specific antigen and CE-TRUS,and further underwent ultrasonic-guided transrectal prostate needle biopsy.The blood perfusion characteristics of benign and malignant prostate lesions under CE-TRUS were compared,including enhancement speed,clearance speed,enhancement uniformity and enhancement intensity.Patients were divided into 3 groups according to serum PSA concentration:4.0ng/ml≤PSA<10.0ng/ml,10.0ng/ml≤PSA < 20.0ng/ml,and PSA≥20.0ng/ml.The diagnostic effect of CE-TRUS on PCa was analyzed in different serum PSA concentration ranges.Results:(1)There were 96 patients in this group,including 62 patients with PCa and 34 patients with benign prostatic diseases confirmed by pathological biopsy.(2)The main characteristics of blood perfusion in PCa patients under CE-TRUS were as follows: 64.52%(40/62)of rapid enhancement,70.97%(44/62)of rapid clearance,83.87%(52/62)of uneven enhancement,and 61.29%(38/62)of high enhancement;The main characteristics of blood perfusion in patients with benign prostate diseases under CE-TRUS were as follows: 70.59%(24/34)non-rapid enhancement,73.53%(25/34)non-rapid clearance,76.47%(26/34)uniform enhancement,and 52.94%(18/34)non-high enhancement.The contrast between PCa and benign prostate diseases in CE-TRUS in enhancement speed,clearance speed and enhancement uniformity showed statistical significance(P < 0.05),while there was no statistical significance between enhancement intensity.(3)The sensitivity of CE-TRUS to PCa in 3 intervals was 58.33%,70.37%,95.65%,the specificity was 83.33%,76.92%,66.67%,and the accuracy was 73.33%,72.50%,92.31%.According to Mc Nemar test and Kappa test for consistency,CE-TRUS showed good consistency in PCa diagnosis in three different serum PSA concentration ranges,with statistical significance,based on pathological results as the "gold standard".Conclusions:There are differences in the enhancement modes of CE-TRUS between benign and malignant prostate lesions,especially in enhancement speed,clearance speed and enhancement uniformity,the observation of the characteristics of blood perfusion under contrast-enhanced transrectal ultrasound is helpful for the differential diagnosis of benign and malignant prostate lesions,and CE-TRUS in different serum PSA concentrations has a certain clinical value in the diagnosis of PCa.