전립선암 진단을 위한 경직장초음파검사에서 저반향병소와 혈류증가의 의의
Significance of Hypoechoic Lesion and Increased Blood Flow on Transrectal Ultrasound for Prostate Cancer Detection
유구한, 전승현, 장성구, 임주원,
소속 상세정보
유구한 ( Yoo Koo-Han )
경희대학교 의과대학 비뇨기과학교실
전승현 ( Jeon Seung-Hyun )
경희대학교 의과대학 비뇨기과학교실
장성구 ( Chang Sung-Goo )
경희대학교 의과대학 비뇨기과학교실
임주원 ( Lim Joo-Won )
경희대학교 의과대학 영상의학교실
KMID : 0358320070480020138
Abstract
Purpose: A hypoechoic lesion is the most common finding of prostate cancer, but its diagnostic value is still an area of debate. The diagnostic significance of a hypoechoic lesion and the increased blood flow observed on transrectal ultrasonography(TRUS) were evaluated for the detection of prostate cancer.
Materials & Methods: The records of 266 patient’s, between January 2003 and December 2005, were retrospectively reviewed. The cancer detection rates were compared according to the presence of a hypoechoic lesion in TRUS, and estimated with respect to stratification of the prostate- specific antigen(PSA) value and digital rectal examination(DRE) findings.
Results: The overall cancer detection rate was higher in the hypoechoic (40 of 101 cases, 39.6%) than in the isoechoic group(30 of 157 cases, 19.1%) (p＜0.05). When the cases were divided into three groups, according to their PSA level(＜4, 4-10 and ＞10), the cancer detection rate apparently increased in those with a hypoechoic lesion in TRUS(10.3 vs. 0%, 25 vs. 13.6% and 68.2 vs. 31% respectively)(p＜0.001). Furthermore, the cancer detection rate was further increased in patients with a hypoechoic lesion than in those with an isoechoic lesion after division into two groups according to the presence of a hard nodule on DRE(with hard nodule, 56.9 vs. 46.7%; without hard nodule, 20 vs. 8.1%, respectively)(p＜0.05). However, hypoechoic lesions with an increased blood flow did not improve the detection rate compared to those without(p＞0.05).
Conclusion: The hypoechoic finding on TRUS not only supports the detection of prostate cancer, but also has independent diagnostic value. However, the findings of color Doppler are not helpful in the detection of prostate cancer. (Korean J Urol 2007;48:138-142)
키워드
Prostate cancer;Biopsy;Ultrasonography
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