The Application Value Of Transrectal Real-time Tissue Elastography In The Diagnosis Of Solid Occupying Lesion Prostate Nodules

Part IComparison of ratio method and score method in the diagnosis ofprostate cancer with transrectal real-time tissue elastographyObjective：To compare score method and ratio method in the diagnosis of prostatecancer with transrectal real-time tissue elastography(TRTE).Methods： Observed67cases of suspected prostate cancer(PCa) patients with theperformance of two-dimensional and elastosonography, calculated elastography scoreand strain index(SI) of the nodules.The curves of receiver operating characteristic(ROC)were built to find the diagnosis point, analysed the values of TRTE score method andthe ratio method in the diagnosis of PCa compared with pathological results.Results：Of these67patients,37had benign lesions and30had PCa. There were3cases1scores,7cases2scores,22cases3scores,32cases4scores,3cases5scores byTRTE score method. With≥4score as a standard to judge malignant, the sensitivity,specificity and accuracy were73.33%,64.86%and68.66%. The average of strainindex(SI) of benign nodules was3.97±5.88(0.45～31.26)，the average of SI ofmalignant nodules was26.91±19.89(2.13～70.66)， It showed statisticaldifference(P<0.05). When a cutoff point of6.67w as used, SI had a sensitivity of86.67%and a specificity of78.38%and the accuracy of82.66%. TRTE ratio methodshowed the difference of SI between benign and malignant nodules, the difference wasstatistically significant (P<0.05). Compared with digital rectal examination(DRE) andtransrectal ultrasonography，there were statistic significance in diagnostic sensitivity,specificity, accuracy between TRTE ratio method and the two above(P<0.05), but therewere no significant difference between score method and TRUS (P>0.05). The difference of diagnostic sensitivity, specificity, accuracy was statistically significantbetween score method and ratio method (P<0.05).Conclusion：TRTE could increase the diagrostic rate of PCa, the ratio methodprovided a more objective and valuable information for the diagnosis of PCa. Part IIRole of Transrectal Real-time Tissue Elastography Combinedwith Serum PSA in The Differential Diagnosis of ProstateBenign and Malignant NodulesObjective：To investigate the value of transrectal real-time tissue elastography(TRTE) combined with serum prostate specific antigen(PSA) in the differentialdiagnosis of prostate benign and malignant nodules.Methods：89patients which have been proved by biopsy or operation completelywith prostate nodules underwent transrectal ultrasonography(TRUS),TRTE and serumPSA detection.58of which were benign prostate hyperplasia, and31of which wereprostate cancer(PCa).The results were analysed statistically.Results：The average of strain index(SI) of benign nodules was2.80±6.66(0.32～30.35)，the average of SI of malignant nodules was30.72±25.05(2.55～75.67)，Itshowed statistical difference(P<0.05). According to the ROC curve,when the cut-offpoint of SI was7.50, the area under curve was0.896,and the diagnostic sensitivity,specificity, accuracy were83.87%、72.41%、76.41%. When the cut-off point of PSAwas11.70, the area under curve was0.827, and the diagnostic sensitivity,specificity,accuracy were77.42%、67.24%、70.79%.The combination of TRTE and serum PSAimproved the diagnostic sensitivity, specificity and the accuracy.The value were93.55%,89.66%and91.00%. Comparing the diagnosis of TRTE combined with serumPSA to a single TRUS and serum PSA1,the difference was statistically significant(P<0.05).Conclusions：Combination of TRTE and PSA can improve the diagnostic rate andoffer a valuable information in the differential diagnosis between benign and malignantprostatic nodules.