The Value Of Shear Wave Elastography In Diagnosis Of Benign Prostatic Hyperplasia

Objective:To explore the value of shear wave elastography in diagnosis of benign prostatic hyperplasia by applying shear wave elastography to measure the prostate transition zone and peripheral zone of benign prostatic hyperplasia.Methods:There were 44 hospitalized patients which were collected from July 2015 to February 2016 in Lanzhou University Second Hospital urology department. We collected TPSA、FPSA、I-PSS、ultrasound examine and other clinical date. 44 patients underwent shear wave elastography to detect the total prostate volume and mean elasticity modulus of the prostate transition zone and peripheral zone. According to the pathological results, all the patients were divided into two groups. Using SPSS19.0 statistical software to analysis all date. Clinical date underwent normality test and homogeneity test of variance. Due to individual variables did not conform to the normal distribution, the correlations between multiple variables used the Spearman-test. The ROC curve was made to get a cut-off elasticity modulus of the prostate transition zone and peripheral zone. P<0.05 means the difference was statistically significant.Results: 1. The AUC of elasticity modulus for transition zone and peripheral zone were 0.703, 0.902, respectively. Youden,s index of transition zone was 0.346, the cut-off point of elasticity modulus was determined as 42.3KPa, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate were 71.0%, 69.2%, 84.6%, 50.0%, 70.5%, respectively. Youden,s index of peripheral zone was 0.752, the cut-off point of elasticity modulus was determined as 24.7KPa, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate were 95.5%, 77.3%, 80.8%, 94.4%, 86.4%, respectively. 2. The elasticity modulus of the transition zone and the peripheral zone had a positive correlation with patient’s age, I-PSS and TPV(P<0.05). 3. When the TPSA level was higher than 4.0ng/ml, the elasticity modulus of the transition zone and peripheral zone were 58.1±5.4KPa, 37.7±7.9KPa, respectively. Otherwise, the elasticity modulus were 44.42±4.8KPa, 25.77±6.0KPa. 4. When the FPSA level was higher than 1.0ng/ml, the elasticity modulus of the transition zone and peripheral zone was 59.6±4.8KPa, 37.4±7.3KPa, respectively. Otherwise, the elasticity modulus was 46.0±6.4KPa, 27.7±8.1KPa。Conclusion: 1. The elasticity modulus of the peripheral zone to diagnosis BPH was exact than the transition zone. The cut-off of elasticity modulus of the prostate transition zone and peripheral zone were determined as 42.3KPa, 24.7KPa, respectively. 2. With the growth of age, I-PSS and prostate volume, the elasticity modulus of transition zone and peripheral zone will become hard. 3. With the rise of the level of TPSA or FPSA, the elasticity modulus of patients with BPH will be increased.