| Objective To analyze different types of benign and malignant prostatic lesions by Shear Wave Elasticity Imaging(SWE);to explore the clinical value of shear wave elastography and conventional ultrasound in differentiating benign and malignant prostatic lesions;and to find the best way to differentiate benign and malignant Young's modulus of prostate lesions by shear wave elastography.To explore the correlation between PSA,IPSS and Gleason scores and elastic modulus of benign and malignant prostatic lesions.Methods: 102 patients were selected from August 2017 to February 2019 in the Department of Urology,Affiliated Hospital of North China University of Science and Technology.According to the pathological results of puncture biopsy,they were divided into benign prostatic lesions group(group I)55 cases and malignant prostatic lesions group(group II)47 cases,all of them were adenocarcinomas.Group I included 30 cases of benign prostatic hyperplasia with chronic inflammation(Group I A),20 cases of benign prostatic hyperplasia(Group I B),2 cases of benign prostatic hyperplasia with acute inflammation,1 case of prostatic tuberculosis and 2 cases of prostatic abscess.Collection parameters included:(1)conventional ultrasound parameters: two-dimensional ultrasound imaging characteristics of prostate: size,internal echo uniformity(uniformity,nonuniformity),capsule(clear,blurred),edge features(smooth,rough),shape(regular,irregular),calcification(yes,no),etc.The blood vessel richness and resistance index were measured by color Doppler.Shear wave elastography parameters: measuring the elastic modulus of interest(KPa),including Emax and Emean.(2)Clinical parameters: age,height,weight and body mass index(BMI).Excel 2003 was used to establish the database and SPSS 17.0 statistical software was used for statistical analysis.Normal distribution measurements are expressed as mean(+)standard deviation.The paired t-test was used for comparison between the two groups,the one-way ANOVA was used for comparison of normal distribution data among multiple groups,the SNK test was used for comparison between two groups,the chi-square test was used for comparison of counting data,and the Pearson correlation analysis method was used for correlation analysis.The difference was statistically significant(P<0.05).With pathological results as the gold standard,the Receiver operating characteristic(ROC)curve was drawn and the area under curve(AUC)was calculated.The statistical significance was AUC > 0.70.The best cut-off point for judging the elastic modulus of benign and malignant lesions was determined according to the Yoden index.Results 1.There was significant difference in the maximum and average values of shear wave modulus between group II and group I A and group I B(P < 0.05).There was significant difference in the ratio of Young's modulus of shear wave between group II and group I A and group I B(P < 0.05).It indicated that the shear wave modulus of elasticity and Young's modulus of shear wave in benign and malignant lesions of prostate were higher than those in group I A and group I B(P < 0.05).In the ratio of Young's modulus of shear wave to the surrounding part,group II > group I.2.Based on the gold standard,the accuracy of shear wave elastography and conventional ultrasound in differentiating benign and malignant prostatic lesions was 80.46% and 66.67%,respectively.The difference was statistically significant(P < 0.05).The accuracy of shear wave elastography was higher than that of conventional ultrasound,which indicated that shear wave elastography was superior to conventional ultrasound in diagnosing benign and malignant prostatic lesions.The technique is superior to conventional ultrasound in comparing benign and malignant prostatic lesions.3.ROC curve analysis of Young's modulus values of benign and malignant prostate lesions: When Emax and Emean were 72.20 and 57.40,the sensitivity and specificity of benign and malignant prostate lesions were 68.3% and 81.8%,respectively;72.10% and 69.40%,indicating that the best threshold value of shear wave elastography for benign and malignant prostate lesions was Emax=72.20 Kpa and Emean=57.40 Kpa.4.There was a correlation between PSA and shear wave elasticity Emax and Emean in benign and malignant prostatic lesions(P < 0.05).5.There was no linear correlation between IPSS score and shear wave elasticity Emax and Emean in benign and malignant prostatic lesions(P > 0.05).6.There was a significant correlation between Gleason score and shear wave elasticity Emax in malignant prostate lesions(P < 0.05).Conclusion 1 The tissue hardness and ratio of prostate adenocarcinoma were higher than those of benign prostatic hyperplasia with chronic inflammation and benign prostatic hyperplasia.2 Shear wave elastography is superior to conventional ultrasound in differential diagnosis of benign and malignant prostatic lesions.3 Shear wave elastography provides a new quantitative diagnostic reference index for evaluating the nature of prostate lesions by ultrasound.When 72.20 KPa and 57.40 KPa are used as the diagnostic threshold of Emax and Emean for benign and malignant prostate lesions,the sensitivity and specificity are the highest,which provides quantitative basis for differential diagnosis of benign and malignant prostate lesions.4 The higher the PSA,the higher the maximum and average shear wave elasticity of benign and malignant prostatic lesions;there was no significant correlation between the severity of clinical symptoms of prostatic lesions and the softness and hardness of prostatic tissue;the higher the Emax of shear wave elasticity of malignant prostatic lesions,the higher the Gleason score.Figure 6;Table 16;Reference 80... |
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