摘要
目的探讨运用经直肠三维超声(3D-TRUS)及应变力弹性成像获得前列腺参数计算梗阻指数在评估良性前列腺增生(BPH)是否存在膀胱出口梗阻(BOO)中的应用价值。方法选取2018年6月至2020年11月在南宁市第一人民医院泌尿外科行尿流动力学检查的BPH患者98例为研究对象,其中膀胱出口梗阻53例,非膀胱出口梗阻45例,根据体积大小分为大体积组(n=64)及小体积组(n=34),运用超声获得两组前列腺移行带指数、突入指数、内腺动脉血流阻力指数及弹性评分,建立一种预测BOO的超声方法并进行分析。结果由梗阻指数绘制梗阻受试者工作特征曲线(ROC曲线),大体积组曲线下面积0.927(P<0.05),说明梗阻指数对梗阻的诊断有意义,最佳临界值为≥9.75分,灵敏度为88.9%,特异度为78.9%。小体积组曲线下面积0.853(P<0.05),最佳临界值为≥6.25分,灵敏度为57.7%,特异度为100%,因该指标灵敏度不高,诊断梗阻价值意义不大。结论运用3D-TRUS联合经直肠应变力弹性成像计算梗阻指数可对大体积BPH是否存在BOO进行评估,方法简单、无创、有效,有一定临床应用价值。
Objective To explore the application value of obstruction index calculated by transrectal three-dimensional ultrasound(3D-TRUS)combined with strain elastography(TRTE)in the evaluation of bladder outlet obstruction(BOO)resulting from benign prostatic hyperplasia(BPH).Methods A total of 98 patients with BPH finished the urodynamics from June 2018 to November 2020 in the Department of Urology,the First People’s Hospital of Nanning were selected,including 53 cases of bladder outlet obstruction and 45 cases of non-bladder outlet obstruction.According to the volume size,the patients were divided into two groups:large-size group(n=64)and small-size group(n=34).The artery resistance index of prostate inner-gland,the index of prostate transitional zone,the protrusion index of prostate,the elasticity score in the two groups were calculated using ultrasound.An ultrasonic method for predicting BOO was established and analyzed.Results Obstructed receiver operating characteristic curve(ROC curve)was drawn by obstruction index.The area under the curve in large-size group was 0.927(P<0.05),which indicated that the obstruction index was helpful to the diagnosis of obstruction,the optimum critical value was greater than or equal to 9.75,the sensitivity was 88.9%,and the specificity was 78.9%.The area under the curve in small-size group was 0.853(P<0.05),the optimum critical value was greater than or equal to 6.25,the sensitivity was 57.7%,and the specificity was 100%.Because the sensitivity of this index was not high in small-size group,it was meaningless for the diagnosis of obstruction.Conclusion The bladder outlet obstruction resulting from large-size benign prostatic hyperplasia could be evaluated by the obstruction index calculated by transrectal three-dimensional ultrasound combined with strain elastography.This method is simple,noninvasive,efficient and of certain clinical application value.
作者
郑文
韦舒静
庞光连
沈春梅
庞姗姗
肖彩意
ZHENG Wen;WEI Shujing;PANG Guanglian;SHEN Chunmei;PANG Shanshan;XIAO Caiyi(Department of Ultrasound,First People’s Hospital of Nanning,Fifth Affiliated Hospital of Guangxi Medical University,Nanning 530022,China;Department of Urology,First People’s Hospital of Nanning,Fifth Affiliated Hospital of Guangxi Medical University)
出处
《山西医科大学学报》
CAS
2021年第4期503-509,共7页
Journal of Shanxi Medical University
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190401)
南宁市科学研究与技术开发计划项目(20193095)。
关键词
良性前列腺增生
经直肠三维超声
经直肠应变力弹性成像
膀胱出口梗阻
梗阻指数
benign prostatic hyperplasia
transrectal three-dimensional ultrasound
transrectal strain elastography
bladder outlet obstruction
obstruction index
