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目的:探讨经直肠实时组织弹性成像(TRTE)联合超声造影(CEUS)在诊断前列腺良恶性疾病中的应用价值。方法:分析经病理证实的88例95个前列腺病灶的超声资料,计算TRTE、CEUS及两者联合诊断前列腺良恶性病变的敏感性、特异性、准确性、阳性预测值和阴性预测值,绘制TRTE、CEUS和两者联合应用的受试者工作特征(ROC)曲线,分别计算三者的曲线下面积(AUC),评估联合应用TRTE和CEUS诊断前列腺良恶性病变的价值。结果:TRTE诊断前列腺病变的敏感性为83.33%,特异性为78.72%,准确性为81.05%,阳性预测值80.00%,阴性预测值82.22%;CEUS诊断前列腺恶性病变对应的敏感性为87.5%,特异性为76.60%,准确性为82.11%,阳性预测值79.25%,阴性预测值85.71%;CEUS联合TRTE诊断前列腺恶性病变对应的敏感性为95.83%,特异性为80.85%,准确性为88.42%,阳性预测值83.63%,阴性预测值95.00%;TRTE的ROC曲线下面积为0.877,CEUS的ROC曲线下面积为0.820,TRTE联合CEUS的ROC曲线下面积为0.894,联合诊断的AUC略高于TRTE和CEUS的AUC,联合诊断的诊断价值稍高。TRTE和CEUS联合诊断的诊断准确性高于单独应用TRTE或CEUS,三者之间行χ2检验,差异有统计学意义(P<0.05)。结论:TRTE联合CEUS在诊断前列腺良恶性疾病中具有较高的价值,两者结合可提高疾病的诊断率。
Objective: To investigate the value of transrectal real-time tissue elastography (TRTE) combined with contrast-enhanced ultrasound (CEUS) in the diagnosis of benign and malignant prostatic diseases. Methods: Ultrasound data of 88 cases of prostate lesions confirmed by pathology were analyzed. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TRTE, CEUS and the combination of the two in the diagnosis of benign and malignant prostatic diseases were calculated. TRTE , CEUS, and their receiver operating characteristic (ROC) curves were calculated. The area under the curve (AUC) of the three was calculated, and the value of combined use of TRTE and CEUS in the diagnosis of benign and malignant prostatic diseases was evaluated. Results: The sensitivity, specificity and accuracy of TRTE in diagnosing prostate disease were 83.33%, 78.72%, 81.05%, 80.00% and 82.22%, respectively. The sensitivity of CEUS in diagnosing benign prostatic diseases was 87.5% The specificity and specificity were 76.60%, 82.11%, 79.25% and 85.71%, respectively. The sensitivity and specificity of CEUS and TRTE in diagnosis of benign prostatic diseases were 95.83%, 80.85% and 88.42% respectively, , The positive predictive value was 83.63% and the negative predictive value was 95.00%. The area under ROC curve of TRTE was 0.877, the area under ROC curve of CEUS was 0.820, the area under ROC curve of TRTE combined with CEUS was 0.894, the AUC of combined diagnosis was slightly higher than that of TRTE And CEUS AUC, the diagnostic value of the joint diagnosis slightly higher. The diagnostic accuracy of combined diagnosis of TRTE and CEUS was higher than that of TRTE or CEUS alone. There was significant difference between the two groups (χ2 test) (P <0.05). Conclusion: The combination of TRTE and CEUS is of great value in the diagnosis of benign and malignant prostatic diseases. The combination of the two can improve the diagnosis rate of the disease.