Transrectal Ultrasonography Combined With Transrectal Realtime Tissue Elastography Valuable For The Diagnosis Of Prostate Cancer

Objective:Through analysis of transrectal ultrasound imaging and transrectal real-time tissue elastography in prostate cancer sonogram of feature, to investigate classification of TRTE strain in prostate disease (especially the diagnostic value of prostate cancer), and the two methods in diagnosis and differential diagnosis of the disease of prostate.Method:Choose in August2011～november2012menstrual clinic of our hospital for diagnosis or suspected prostate cancer, or found metastatic tumor suspected primary foci in prostate and hospitalized patients (50cases with real-time ultrasound elasticity image evaluation standard), all the patients were treated with digital rectal examination (DRE), serum prostate specific antigen test (PSA), transrectal ultrasound (TRUS), transrectal real-time tissue elastography (TRTE) and ultrasound guided biopsy of the prostate. According to the characteristics of elastic strain within the lesion, which is divided into5levels, and the results were compared with pathology.Results:1、50cases of pathological findings in patients with PC A were19cases (positive rate38%), benign prostatic hyperplasia (BPH) in10cases (positive rate20%), BPH with inflammation in21cases (positive rate42%).2、 Transrectal real-time elastography strain diagram grade～(4cases) was found in malignant, Ⅱ-Ⅴ grade malignant ratio was13.6%(3/22),62.5%(10/16),71.4%(5/7),100%(1/1). The difference between level5with statistical significance (X2=17.0, P<0.001)3、 The sensitivity of TRUS in the diagnosis of prostate cancer (Sen) was78.9%, specificity (Spe) was67.7%, the false positive rate (FPR) was32.3%, the false negative rate (FNR) was21.1%, the positive predictive value (PPV)41.7%, the negative predictive value (NPV) of71.4%; the sensitivity of TRTE in the diagnosis of prostate cancer was84.2%, special the false positive rate was74.2%, specificity was25.8%, the false negative rate was15.8%, the positive predictive value of predictive value of72.7%, negative41%; the diagnosis of TRUS and TRTE combined with sensitivity, specificity, false positive rate, false negative rate, positive predictive value, and negative predictive value were89.5%,70.9%,29.1%,10.5%,43.6%and81.8%. The combination of the two after sensitivity, positive predictive value, and negative predictive value were obviously improved alone any inspection, specificity and accuracy than TRUS alone diagnosis rate increase.Conclusion:Transrectal ultrasound and real-time tissue elastography combined have important value in diagnosis of prostate diseases, both in the diagnosis of prostate cancer and benign disease and preoperative accurate rate higher than that of TRUS alone, but also better than that of the single TRTE method. The TRUS has higher sensitivity for prostate abnormal echo nodules, but the specificity is not high. Transrectal ultrasound prostate abnormal echo nodules, especially peripheral hypoechoic lesion, and TRTE grade in the grade III (elastic graph lesions mainly blue) has a certain value in malignant tumor. The combined use of the two methods can improve the detection rate of prostate cancer, reduce misdiagnosis, provide important information for clinical diagnosis.