| ObjectiveBenign prostatic hyperplasia(BPH)in men is common diseases that affectes the quality of patients' life seriously.Because BPH can produce a variety of complications and impact on the quality of patients' life,the degree of concern for BPH has increased recently.BPH can be cured by operation.Understanding of pathological anatomy of the prostate can guide clinical treatment options.Three-dimensional ultrasound is a new technology which carried out in recent years.Multi-planar imaging can accurately indicate changes in the structure of prostate anatomy,especially can accurately measure the prostate volume.A considerable amount of research has proven it's accuracy and repeatability.We observe prostate size and shape character in patients with BPH groups and control groups and use Virtual Organ Computer-Aid Analysi(VOCAL)to measure the total prostate volume(TPV),transitional zone volume(TZV),intravesical prostatic protrusion(IPP),and calculate the transition zone index(TZI).In this study,we aim to analyze the relationship between clinical symptoms parameters,urodynamic parameters and prosratic volume,and to assess the significance of three-dimensional transrectal ultrasonography(3D-TRUS).Material and MetheodFrom May 2007 to January 2008,30 cases with BPH were recruited into the study at Department of ultrasound,Shengjing Hospital.All the BPH patiens were underwent 3D-TRUS scan before surgery.During the study period,30 healthy men were selected as controls.The equipment used in the study was Kretz Voluson 730D(GE Co.)with 5-9MHz endoprobe.Firstly,conventional scanning observed the sonographic features of the prostate by two-dimensional transrectal ultrasonography(2D-TRUS).Then,enter the 3D/4D mode.3D-TRUS was carried out after 2D-TRUS examination had been completed. VOCAL application procedures can automatically calculate the prostate volume parameters such as TPV,TZV,IPP,and it selected rotation angle of 15°intervals,a total of 12 prostate tissue section,and each section outlined envelope from the apparatus.All cases were analysed by same doctor and all the data was calculated three times to remove the average.The statistical data were analyzed using the SPSS 14.0(Statistical Package for the Social Sciences).Data are represented as mean±standard deviation,independent samples t test was used between normal prostate and hyperplasia prostate.Correlation analysis was used Spearman rank correlation analysis.P＜0.05 was considered to be statistical significant.ResultsAll the patients and controls tolerated the examination without remarkable discomfort. 3D-TRUS can cleraly showe the anatomy charactors of BPH.Men with BPH, compared with control groups,have significant differences in TPV,TZV,TZI(P＜0.01).The pairwise correlation between TPV and TZV is obviously(r=0.96,P＜0.01).The pairwise relationships between Age,PSA and TPV,TZV is significant.The pairwise correlations between Internation symptom score(IPSS)versus TPV,TZV,TZI and IPP is not statistically or clinically significant.The pairwise correlations between IPP and AG is statistically significant(r=0.609,P＜0.001).According to AG≥40,the BPH patients are divided into BOO groups and non-BOO groups,and there is significant difference between TZV,TZI and IPP in the two groups(P＜0.05).Conclusion1.3D-TRUS can cleraly show the anatomy characters of BPH.VOCAL can automatical calculated TPV,TZV and IPP.It is a good tool to assess the change of prostate.2.These findings provide further evidence that the TZV,TZI and IPP are useful determinants of the severity of clinical BPH.Can not be carried out for urodynamic analysis,the comprehensive analysis of these indicators will help determine whether the bladder outlet obstruction and degree.
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