經腹部超音波與經直腸超音波檢查在良性攝護腺增生的診斷差異：以測量攝護腺總體積大小做為比較

Differential Diagnosis of Benign Prostatic Hyperplasia Transabdominal Ultrasonography and Transrectal Ultrasonography in the Differential Diagnosis of Benign Prostatic Hyperplasia-As Comparative to measure the Total Volume of the Prostate

張晏禎(Yen-Chen Chang) ； 張美彥(Mei-Yen Chang) ； 王安中(An-Chueng Wang) ； 張建法(Chien-Fa Chang) ； 邱宏仁(Hong-Jen Chiou)

《北市醫放雜誌》 8卷1期 (2018/12) Pp. 9-14

https://doi.org/10.6663/TPART.201812_8(1).0002

摘要

攝護腺肥大是男性最常見的良性攝護腺增生，臨床上最常使用超音波追蹤攝護腺大小，而超音波檢查方式又分兩種，一個是經腹部超音波(Transabdominal ultrasonography，簡稱TAUS)，另一個是經直腸超音波檢查(Transrectal ultrasonography，簡稱TRUS)。本次研究的目的在於，當臨床如果只使用超音波追蹤攝護腺大小時，經直腸超音波檢查及經腹部超音波測量攝護腺大小的差異，是否會影響攝護腺肥大的診斷。本研究採用回溯性研究分析，收集期間自2015/10/01～2016/9/30一年間，平均72歲(34-97歲)的91位男性受檢者的檢查資料。每一位受檢者在同一天同一次檢查中，由同一位放射師依序完成經腹部超音波及經直腸超音波檢查二種方式的檢查，依據所測量得的攝護腺大小，執行成對母體平均數差異檢定(t檢定)分析。研究結果為經腹部超音波測量的平均值為51.18 cm^3，大於經直腸超音波測量的平均值43.02 cm^3，P值＜0.001，R^2值大於0.7，具有統計學上顯著相關性。根據ANOVA統計及相關係數迴歸分析結果為R^2=0.925（趨近於1），表示經腹部超音波與經直腸超音波有極高度的相關性，由線性迴歸點狀圖顯示，經腹部超音波與經直腸超音波呈現密集的點狀分佈，且趨近於一條直線，r＝1.156x+5E-14，R^2=1。證實在利用攝護腺總體積大小來診斷良性攝護腺增生時，使用經腹部超音波與經直腸超音波評估攝護腺大小，具有相同的診斷價值。因此，簡單、方便、低成本的經腹部超音波檢查，適合做為健保低給付的初步診斷工具。

關鍵字

經腹部超音波 ； 經直腸超音波 ； 測量攝護腺大小

並列摘要

Benign prostatic hyperplasia (BPH) is a common disease of ageing men worldwide. Prostate volume is an important parameter. It can be measured in several ways using ultrasonography. Transabdominal and Transrectal ultrasonography (TAUS and TRUS) were as the standard clinical tool for a rapid, simple and non-invasive screening of the prostate volume. This study aimed at comparing the volume estimation of the prostate on transrectal and Transabdominal ultrasound with patients with BPH and to suggest better predictor of prostate volume in evaluation of BPH. This is a retrospective comparative study carried out between October 1st, 2015 and September 30, 2016 and collected 91 male subjects with mean age 72 years (rang from 34-97 years).Each subject in the same examination on the same day, the same radiolographer completed the Transabdominal Ultrasonography and Transrectal Ultrasonography two methods in order. The data of prostate size was correlated in both Transabdominal Ultrasonography and Transrectal Ultrasonography with Pearson's correlation ,regression analysis and paired sample T-test. The mean value of Transabdominal Ultrasonography was 51.18 cm^3 and greater than 43.02 cm^3 of the mean value of Transrectal Ultrasonography. Result: It was statistically significant (r =1.156x + 5E-14 , p ＜ 0.001) difference in the prostatic size. An analysis of variance (ANOVA) shows higher association with R-squared (R^2) of 0.925 (p ＜ 0.001) and indicating that Transabdominal Ultrasonography has a very high correlation with Transrectal Ultrasonography. The linear regression dot plot shows that Transabdominal Ultrasonography and Transrectal Ultrasonography are dense dot-like distribution, and tend to near straight line, the formula is r = 1.156x + 5E-14, R^2 = 1. It was confirmed that use of Transabdominal Ultrasonography and Transrectal Ultrasonography to assess prostate size has the same diagnostic value when using the total volume measures of the prostate to diagnose BPH. Therefore, the simple, convenient and low-cost insurance in the Transabdominal Ultrasonography examination is suitable as a preliminary diagnostic tool for healthcare.

並列關鍵字

Transabdominal ultrasonography ； Transrectal ultrasonography ； Measurement of prostate size