中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (2): 177-183.doi: 10.19438/j.cjoms.2022.02.014

• 论著 • 上一篇    下一篇

腮腺超声造影对43例腮腺肿瘤的诊断价值评价

陈泽源1,2, 刘怡彬3, 再米热·依布拉音3, 张思敏1,2, 买买提吐逊·吐尔地1,2   

  1. 1.新疆医科大学第一附属医院（附属口腔医院） 颌面创伤正颌外科,新疆 乌鲁木齐 830054;
    2.新疆维吾尔自治区口腔医学研究所,新疆 乌鲁木齐 830054;
    3.新疆医科大学第一附属医院 超声诊断科,新疆 乌鲁木齐 830054
  • 收稿日期:2021-10-11 修回日期:2021-11-24 出版日期:2022-03-20 发布日期:2022-03-20
  • 通讯作者: 买买提吐逊·吐尔地,E-mail：maimaitituxun@aliyun.com
  • 作者简介:陈泽源（1994-）,男,在读硕士研究生,E-mail：530358348@qq.com

Evaluation of the value of contrast-enhanced ultrasonography in diagnosis of43patients with parotid tumors

CHEN Ze-yuan1,2, LIU Yi-bin3, ZAIMIRE Yibulayin3, ZHANG Si-min1,2, MAIMAITITUXUN Tuerdi1,2   

  1. 1. Department of Oral and Maxillofacial Trauma and Orthognathic Surgery, First Affiliated Hospital (Stomatological Hospital) of Xinjiang Medical University. Urumqi 830054;
    2. Institute of Stomatology, Xinjiang Uygur Autonomous Region. Urumqi 830054;
    3. Department of Ultrasound, First Affiliated Hospital of Xinjiang Medical University. Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Received:2021-10-11 Revised:2021-11-24 Online:2022-03-20 Published:2022-03-20

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摘要： 目的:探讨超声造影在腮腺肿瘤鉴别诊断中的价值。方法:选择行手术治疗及腮腺超声造影检查的腮腺肿瘤患者43例（良性31例,恶性12例）。造影检查时,收集超声造影图像特征,包括增强时间（快进、慢进或等进）,消退时间（慢退、快退及等退）,增强强度（高增强、等增强及低增强）,增强均匀程度（均匀、不均匀）,并勾画感兴趣区,绘制时间-强度曲线图。通过仪器分析,得出定量参数,包括到达时间、达峰时间、峰值强度（PI）、上升斜率（AS）、峰值降半时间、半降支斜率（DS）、曲线下面积（AUC）以及肿瘤与周围正常组织间参数差值,使用参数前△符号表示,对数据进行分析,得出腮腺肿瘤超声造影表现、定量参数的差异、再以定量参数绘制受试者工作特征曲线,得出最佳截断值、灵敏度及特异度。采用SPSS 25.0软件包对数据进行统计学分析。结果:腮腺良性肿瘤的增强时间、增强强度、增强均匀程度及消退时间与恶性肿瘤有统计学差异（P<0.05）。腮腺良性肿瘤中,多形性腺瘤（PA）与Warthin（WT）瘤的△AUC之间差异显著（P<0.05）;腮腺良性肿瘤组与恶性肿瘤组肿瘤组织中,DS、AUC、△PI、△AS及△AUC差异有统计学意义（P<0.05）。ROC曲线分析显示,PA与WT的△AUC最佳截断值为-103.94,灵敏度为100%,特异度为46.20%（ROC-AUC=0.766,P<0.05）。腮腺良恶性肿瘤中,AUC的最佳截断值为1422.165,灵敏度为83.30%,特异度为60%（ROC-AUC=0.728,P<0.05）;△PI的最佳截断值为0.535,灵敏度为83.30%,特异度为60%（ROC-AUC=0.794,P<0.05）;△AUC的最佳截断值为271.37,灵敏度为91.7%,特异度为60%（ROC-AUC=0.797,P<0.05）。结论:超声造影对腮腺肿瘤的鉴别诊断具有重要价值。

关键词: 腮腺肿瘤, 超声造影, 时间-强度曲线图, 定量分析

Abstract: PURPOSE: To evaluate the value of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of parotid tumors. METHODS: This study cohort comprised 43 patients with parotid gland tumors. The pathological classification of tumors included 31 benign tumors and 12 malignant tumors. The characteristics of CEUS images collected during ultrasound examination included wash-in pattern (fast in, slow in or isochronous), wash-out pattern (fast out, slow out and isochronous), enhancement intensity (hight, equal or low), and texture of enhancement (homogeneous and heterogeneous ).The region of interest (ROI) was outlined, the time intensity curve (TIC) was drawn, and the quantitative parameters were obtained through instrumental analysis, including time of arrival (AT), time of peak arrival (TTP), peak intensity (PI), ascending slope(AS), descending time/2 (DT/2), half falling branch slope (DS) and area under the curve(AUC). Then, through the travel value of the parameters between the tumor and surrounding normal tissue, △symbol was added before using the parameters. Based on the analysis of the data, CEUS performance among parotid tumors and difference of quantitative parameters were obtained, and then quantitative parameters were drawn to the working characteristic curve of the subjects to get the best cut-off value, sensitivity and specificity. SPSS 25.0 software package was used for data analysis. RESULTS: There were significant differences between benign parotid tumors and malignant tumors in wash-in pattern, wash-out pattern, enhancement intensity and texture of enhancement(P<0.05).There was significant difference in △AUC between pleomorphic adenomas (PA) and Warthin's tumor (WT) in benign parotid tumors (P<0.05). There were significant differences in DS, AUC, △PI, △AS and △AUC between benign and malignant parotid tumors(P<0.05). Analysis of ROC curve showed that the best cut-off value of △AUC of PA and WT was -103.94, the sensitivity was 100%, and the specificity was 46.20%（ROC-AUC=0.766,P<0.05）. In benign and malignant tumors of parotid gland, the best cut-off value of AUC was 1422.165, the sensitivity was 83.30%, the specificity was 60%（ROC-AUC=0.728,P<0.05）; the best cut-off value of PI was 0.535, the sensitivity was 83.30%, and the specificity was 60%(ROC-AUC=0.794,P<0.05); the best cut-off value of △AUC was 271.37, the sensitivity was 91.7%, and the specificity was 60% (ROC-AUC=0.797, P<0.05). CONCLUSIONS: CEUS has important value in differential diagnosis of parotid tumors.

Key words: Parotid tumor, Contrast-enhanced ultrasound, Time-intensity curve, Quantitative analysis

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