A Comparative Study Of The Value Of Transrectal Ultrasound Combined With Elastic Imaging And Magnetic Resonance In Diagnosis Of Different Gleason Score Prostate Carcinoma

ObjectiveTo comparatively analyze the value of transrectal real-time elastography?TRTE?on the basis of transrectal ultrasound?TRUS?and magnetic resonance T₂-weighted imaging?T₂WI?combined with diffusion weighted imaging?DWI?in diagnosis of benign and malignant prostate lesions and diagnostic value in different Gleason score Prostate carcinoma?Pca?.Materials and Methods78 cases of suspected Pca patients were examined by TRUS,TRTE and T₂WI,DWI examinations,and finally were confirmed by biopsy pathology,including 20 cases of benign group and 58 cases of malignant group.58 cases of Pca were divided into the low-risk group?<Gleason score 7?of 27 cases,the average risk group?Gleason score 7?18 cases,the high-risk group of 13 cases?>Gleason score 7?.By biopsy pathology as the gold standard,the results were dealed by using statistical software.Result:1.The sensitivity,specificity and accuracy of the diagnosis of benign and malignant prostate lesions by TRUS+TRTE were 70.69%?41/58?,80%?16/20?,73.08%?57/78?.2.The SR results were as follows:?1?The SR of low-risk group,average risk group and high-risk group was higher than benign group?P<0.05?,the SR of high-risk group was higher than low-risk group and average risk group?P<0.05?.?2?When the maximum youden index was 0.610,the corresponding cut off value of the SR was 3.36,the sensitivity,specificity and accuracy of the diagnosis of benign and malignant prostate lesions by the SR were 81.03%?47/58?,80.00%?16/20?,80.77%?63/78?.3.The AUC of elastic SR method 0.805 was higher than the AUC 0.788 of TRTE scoring method.Based on by TRUS,the accuracy of the diagnosis of benign and malignant prostate lesions by elastic SR method was higher than TRTE scoring method,but there was no statistically significant difference?P>0.05?.4.The sensitivity,specificity and accuracy of the diagnosis of benign and malignant prostate lesions by T₂WI+DWI were 84.48%?49/58?,85.00%?17/20?,84.62%?66/78?.5.Comparison between the sensitivity,specificity and accuracy of the diagnosis of benign and malignant prostate lesions by TRUS+TRTE and T₂WI+DWI,T₂WI+DWI was higher than TRUS+TRTE,but the difference had no statistical significance?P>0.05?.The positive detection rate of low-risk group by T₂WI+DWI was higher than TRUS+TRTE?P<0.05?.In the average risk and high-risk group,the positive detection rates of T₂WI+DWI and TRUS+TRTE were approximately equal?P>0.05?.Conclusion:1.TRUS+TRTE is available for qualitative and quantitative analysis of prostate lesions hardness,and has certain value in diagnosis of benign and malignant prostate lesions and diagnostic value in different Gleason score Pca.2.The diagnostic capability of T₂WI+DWI is slightly higher than TRUS+TRTE in diagnosis of benign and malignant prostate lesions,but the difference has no statistical significance?P>0.05?.In the low-risk group,the diagnostic value of T₂WI+DWI is higher than TRUS+TRTE,while in the average risk group and high-risk group,the diagnostic value is approximately equal.