Qualitative analysis of ultrasound with intravenous contrast in the differential diagnosis of focal formations of the prostate gland

Khasanov M.Z., Tukhbatullin M.G.

Purpose. To assess the possibilities of qualitative analysis of contrast enhanced ultrasound in the diagnosis of focal formations of the prostate gland.

Materials and methods. Ultrasound with contrast enhancement («Sulfur hexafluoride », 2,4 ml per study) was performed on 66 patients (46-82 years old): 40 patients – a group with prostate cancer (PCa), 26 – a comparison group.

Results. Qualitative signs of CEUS were evaluated: the clarity of the contours, the nature of the contrast (uniformity), the intensity of the contrast, the rate of accumulation and washing out of the ultrasound contrast agent (UCA) in the focal formation of the prostate gland. Hypercensity was characterized by hyperintensive contrast compared with the unchanged parenchyma in 23/57.5% of cases, rapid accumulation of UCA in 22/55% of cases and rapid leaching of UCA in 23/57.5% of cases. The informativeness of the signs in the diagnosis of prostate cancer was: hyperintensive contrasting of the focal formation (Se 58%, Sp 69%), the rapid accumulation of UCA in the focal formation (Se 82%, Sp 78%), the rapid washing out of the UCA from the focal formation (Se 58%, Sp 96%).

Discussion. Maximum sensitivity showed a sign of "rapid accumulation of UCA in the hearth of relatively intact parenchyma" 82%, the maximum specificity showed signs of "non different nature of the contrast of the hearth" and "rapid washing of the UCA in the hearth of the relatively intact parenchyma" by 96%, the maximum accuracy showed a sign of "rapid washing of the UCA in the hearth of the relative-act parenchyma" – 73%. Maximum values of the prognosis of the positive result and the prognosability of the negative result were typical for the sign of "rapid washing of the UCA in the hearth of a relative intact parenchyma" – 96%/60%.

Conclusion. The qualitative sign “the accumulation rate of UCA in focal prostatic formation relative to the intact region” showed the maximum informative value in the diagnosis of prostate cancer. The significance of the analyzed qualitative signs of CEUS was higher than standard methods for the qualitative assessment of vascularization.

 

Kazan State Medical Academy (Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuing Professional Education»). Kazan, Russia.

 

Keywords: prostate gland, prostate cancer, ultrasound with contrast enhancement, qualitative analysis.

 


Corresponding author:  Khasanov M.Z., e mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Khasanov M.Z., Tukhbatullin M.G. Qualitative analysis of ultrasound with intravenous contrast in the differential diagnosis of focal formations of the prostate gland. REJR 2021; 11(2):209-218. DOI: 10.21569/2222-7415-2021-11-2-209-218.

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Received:       16.04.20 Accepted:     25.03.21