涎腺混合瘤和Warthin′s瘤的超声造影对比  

Comparison of salivary pleomorphic adenoma and Warthin′s tumor in contrast enhanced ultrasound

作　　者：蒋丽萍[1] 周爱云[1] 王婧玲 Jiang Liping;Zhou Aiyun;Wang Jingling(Department of Ultrasound,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院,330006

出　　处：《中华医学超声杂志（电子版）》2018年第7期502-505,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：江西省卫生计生委科技计划(20175130)

摘　　要：目的对比分析涎腺混合瘤(PA)和Warthin′s瘤的超声造影(CEUS)特点。方法回顾性分析2016年6月至2017年11月在南昌大学第一附属医院就诊的65例涎腺肿块患者,对49例涎腺混合瘤患者49个肿块及16例Warthin′s瘤患者的21个肿块进行超声造影检查,获得肿块及周边正常涎腺组织的时间-曲线(TIC),记录并分析达峰时间(TTP)、曲线下面积(AUC)、峰值强度(PI)和峰值半降时间(TFP)等数据,并进行2组间比较分析。手术病理结果及细针穿刺结果为诊断的金标准。结果 PA组和周边正常涎腺组织的TTP、AUC、PI、TFP分别为(15.23±7.20)s、(366.04±121.59)dB.s、(7.88±2.19)dB、(37.66±11.98)s和(14.76±5.97)s、(319.82±127.46)dB.s、(6.97±2.38)dB、(41.53±15.11)s,两者比较,差异无统计学意义(t=0.352、1.836、1.970、-1.408,P均>0.05),PA于注射造影剂后呈等进等退、不均匀性等增强;Warthin′s瘤组与周边正常涎腺组织的TTP、AUC、PI、TFP分别为(20.57±5.64)s、(548.42±320.22)dB.s、(8.480±1.94)dB、(61.64±23.64)s和(22.07±6.54)s、(346.98±279.68)dB.s、(6.01±2.51)dB、(47.61±16.40)s,两者比较,除TTP之外,差异均有统计学意义(t=6.299、5.658、4.697,P均<0.05),Warthin′s瘤为等进慢退、高增强。以慢进和高增强鉴别诊断两者的敏感度、特异度、准确度分别为85.7%(18/21)、69.4%(34/49)、74.2%(52/70)和90.4%(19/21)、42.9%(21/49)、57.1%(30/70)。结论注射造影剂后,涎腺PA表现为等进等退、不均匀性等增强,而Warthin′s瘤表现为等进慢退、高增强,应用后者的特点对Warthin′s和PA进行鉴别诊断具有较高的敏感度。Objective To compared the feature of contrast enhanced ultrasound(CEUS)between salivary pleomorphic adenoma(PA)and Warthin′s tumors.Methods A total of 65 patients with salivary tumor in the First Affiliated Hospital of Nanchang university from June 2016 to November 2017 were analyzed retrospectively.The 49 patients with 49 PAs and 16 patients with 21 Warthin′s tumors underwent contrast enhanced ultrasound,then time-intensity curve(TIC)of tumors and surrounding area were acquired.The values of time to peak(TTP),area under the curve(AUC),peak intensity(PI)and time from peak to one half(TFP)were recorded and analyzed.The pathological results and fine needle aspiration results were regarded as the gold standard for diagnosis.Results The TTP,AUC,PI,TFP in PA and surrounding salivary glands were(15.23±7.20)s,(366.04±121.59)dB.s,(7.88±2.19)dB,(37.66±11.98)s and(14.76±5.97)s,(319.82±127.46)dB.s,(6.97±2.38)dB,(41.53±15.11)s,respectively.However,there was no statistical difference between PA tumors and surrounding salivary glands(t=0.352,1.836,1.970,-1.408,all P>0.05).PA manifested heterogeneous iso-enhancement with identical in and identical out in CEUS.TTP AUC,PI,TFP in warthin′s tumors and surrounding salivary glands were(20.57±5.64)s,(548.42±320.22)dB.s,(8.480±1.94)dB,(61.64±23.64)and(22.07±6.54)s,(346.98±279.68)dB.s,(6.01±2.51)dB,(47.61±16.40)s,respectively.Except for TTP,there were remarkable statistical differences between warthin′s tumors and surrounding salivary glands(t=6.299,5.658,4.697,all P<0.05).Warthin′s tumors showed hyper-enhancement with identical in and slow out in CEUS.Using slow wash-out and hyperenhancement as the criteria,the sensitivity,specificity and accuracy in differential diagnosis of the two tumors were 85.7%(18/21),69.4%(34/49),74.2%(52/70)and 90.4%(19/21),42.9%(21/49),57.1%(30/70),respectively.Conclusions PA manifested heterogenous iso-enhancement with identical in and identical out,while Warthin′s tumors showed hyper-enhancement with identical in and slow out in

关 键 词：超声造影 混合瘤 Warthin′s瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学]