台中榮總在最近一年半，以經直腸攝護腺超音波檢查及超音波導引下經會陰攝護腺切片檢查，來診斷108位攝護腺觸診異常病人。超音波可以顯示出75例(69.4％)的病灶，即低音影有24位(22.2％)，高音影36位(33.3％)，混合音影15位(13.9％)。而在108位中29例(26.8％)經一次切片證實為攝護腺癌，另有3例經再次切片證實為癌症。攝護腺觸診異常可分為三大類：⑴ 觸診非常硬的病人有35位，21位(60％)證實為癌症 ⑵ 明顯結節的病人有26位，5位(19％)為癌症 ⑶ 觸診稍硬的病人有47位，只有3位(6.4％)為癌症。32位攝護腺癌症病人中，14位(43％)在超音波檢查下呈現低音影病灶，4位(13％)呈現高音影，10位(31％)呈現混合音影。另外有4位(13％)呈現均勻音影，無法與周圍組織區分。在最近的33位病人，我們除了上述檢查外，同時也作了以手指導引下經會陰攝護腺切片檢查來比較超音波導引及手指導引切片在診斷癌症上，孰優劣？在8位被證實攝護腺癌的病人，其中2位以兩種切片方法皆可診斷，3位只能由超音波導引下切片得到診斷，另外3位只能由手指導引下切片得到診斷。這項觀察顯示經直腸攝護腺超音波檢查可輔助肛門指診來診斷攝護腺癌；在攝護腺觸診異常病人的診斷上，超音波導引及手指導引經會陰攝護腺切片檢查，兩者相輔相成，可提升癌症的診斷率。

Transrectal prostatic ultrasonography and ultrasound guided transperineal core biopsy were performed on 108 consecutive men who had abnormal prostate upon digi-tal rectal examination. These procedures demonstrated compatible ultrasonic abnormali-ties in 75 (69.4) of the cases, which included hypoechoic lesions in 24 (22.2%), hy-perechoic lesions in 36 (33.3%) and mixed echogenicity in 15 (13.9%). 29 of the 108 patients (26.8%) were positive for prostate carcinoma by first set biopsy, another 3 cases were proved as carcinoma by repeated biopsy. Digitally guided transperineal biopsy was also conducted in the most recent 33 cases. Eight patients were diagnosed as having prostate carcinoma. Of them 2 carci-nomas were detected by both techniques, while in 3 cases the carcinoma was detected by ultrasound guided biopsy only and another 3 carcinoma was detected by digitally guided biopsy only. These observations indicate that transrectal ultrasonography is an adjunctive tool to the digital rectal examination, and that the combination of the digi-tal guided biopsy and ultrasound guided transperineal biopsy can increase the accuracy in diagnosing prostate carcinoma in the man with a palpable abnormality of the prostate. (J Urol R.O.C., 2:365-371, 1991)