彩色多普勒超声鉴别涎腺良恶性肿瘤的临床应用研究  

Clinical application of color ultrasonic doppler in the diagnosis of benign and malignant tumors of salivary glands

作　　者：郭军[1] 封兴华[2] 孟庆江[1] 张浚睿[2] 郑文[1] 孙琰[1] 雷德林[2] 

机构地区：[1]西安第四军医大学口腔医院影像科,710032 [2]西安第四军医大学口腔颌面外科,710032

出　　处：《实用口腔医学杂志》2005年第2期256-258,共3页Journal of Practical Stomatology

摘　　要：目的:评价多种超声检查方法在鉴别涎腺良恶性肿瘤方面的作用,提高诊断的准确性。方法:用二维声像图(2DUS)、彩色多普勒血流显像(CDFI)、彩色多普勒能量图 (CDE)和脉冲多普勒 (PWD)等超声方法检查涎腺肿瘤 142例,按肿块的 2DUS特征和CDFI血流特点判定为良性和恶性,检查结果与手术后病理对照。将同一肿块的CDFI与CDE血流显示情况及其血流动力学指标进行对比分析。结果: 2DUS检查肿瘤内部的特殊性回声及后回声在良恶性肿瘤诊断中特异性较高(87. 4% )。CDFI可清晰显示肿瘤内的血流形态。除腺淋巴瘤外良性肿瘤中 78. 7%表现为血流Ⅰ或Ⅱ -级,恶性肿瘤中 80. 0%表现为Ⅱ +或Ⅲ级。恶性肿瘤内动脉的最大血流速度(PSV)高于良性肿瘤。CDE对肿瘤内血流显示率高于CDFI,但在良恶性肿瘤鉴别方面与CDFI相比无明显优势。各种超声检查方法联合应用诊断:灵敏度 89. 3%、特异度 90. 5%,假阴性率 10. 6%、假阳性率 9. 5%,准确率 90. 1%,阴性预告值 94. 5%,阳性预告值 82. 4%。结论:各种超声检查方法联合应用,可以明显提高超声对涎腺良恶性肿瘤诊断的准确性。Objective:To evaluate 2D ultrasonography(2DUS), color Doppler flowing imaging(CDFI) and color Doppler energy (CDE) in the differential diagnosis of benign and malignant tumors of salivary glands.Methods:According to the characters of 2DUS and CDFI examination, benign and malignant tumors in 142 cases of salivary glands were distinguished. The results of ultrasound examination and postoperative biopsy were checked and compared. Meanwhile the same tumor's blood flow information and hemodynamics index were compared. Results:In 2DUS examination, the inter echo and post echo of benign and malignant were different. In CDFI examination, the blood flow form could be displayed clearly. Besides Warthin tumors, the blood supply ranking of benign tumors was usually levelⅠor Ⅱ-(78.7%), and that of malignant tumors was levelⅡ+ or Ⅲ(80.0%). The artery's peak systolic velocity(PSV) of malignant tumors was higher than that of benign tumors. The rates(%) of sensitivity, specificity,accuracy,false negative, false positive, positive predicting and negative predicting of 2DUS were 70.2,87.4,81.7,29.8,12.6,73.3 and 85.6,those of CDFI 80.9,65.2,70.4,19.1,34.7,53.0 and 87.3,those of the integrated usage of ultrasonic methods 89.3,90.5,90.1,10.6,9.5,82.4 and 94.5 respectively.Conclusion:With the integrated usage of ultrasonic methods, higher accuracy of differential diagnosis for benign and malignant salivary glands tumors may be obtained.

关 键 词：涎腺肿瘤 二维声像图 彩色多普勒血流显像 彩色多普勒能量图 鉴别诊断 

分 类 号：R739.8[医药卫生—肿瘤]