腮腺多形性腺瘤和沃辛瘤的超声特征对比分析  

Comparative analysis of ultrasonic characteristics of pleomorphic adenoma and Warthin tumor of parotid gland

作　　者：金朋 蒋翠萍 陈松旺[1] 陈洁[2] 石岩 张柳婷 郭培杰[1] JIN Peng;JIANG Cuiping;CHEN Songwang;CHEN Jie;SHI Yan;ZHANG Liuting;GUO Peijie(Department of Ultrasound,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing First Hospital,Nanjing 210012,Jiangsu Province,China;Department of Radiotherapy,Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,Jiangsu Province,China;Department of Ultrasound,Affiliated Hospital of Binzhou Medical College,Binzhou 256699,Shandong Province,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)超声科,江苏南京210012 [2]南京医科大学附属肿瘤医院放疗科,江苏南京210009 [3]滨州医学院附属医院超声科,山东滨州256699

出　　处：《肿瘤影像学》2022年第2期174-180,共7页Oncoradiology

摘　　要：目的:探讨超声鉴别诊断腮腺多形性腺瘤和沃辛瘤(Warthin tumor,WT)的临床价值。方法:回顾并分析经超声检查并经手术后病理学检查确诊的45例腮腺多形性腺瘤和71例腮腺WT患者资料,选择两组患者的性别、年龄、是否多发、病灶长径、短径、长短径之比、形态、边界、内部回声高低、内部回声均匀性、囊病变、网状条索、钙化、后方回声和血流分级等指标,通过绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析超声指标对腮腺WT的诊断效能。结果:两组患者在性别、年龄、是否多发、病灶长径、长短径之比、形态、内部回声高低、内部回声均匀性、囊性变、网状条索、后方回声和血流分级指标上差异有统计学意义(P<0.05)。根据曲线下面积(area under the curve,AUC)筛选出鉴别诊断价值最高的3项超声特征分别为网状条索、血流分级和长短径之比。网状条索诊断WT的灵敏度68.49%,特异度95.56%,AUC为0.820;血流分级诊断WT的灵敏度76.56%,特异度71.43%,AUC为0.740;长短径之比以1.51为截断值,诊断WT的灵敏度65.80%,特异度80.00%,AUC为0.708。结论:腮腺多形性腺瘤和WT的超声表现具有显著差异,特别是当肿瘤内出现网状条索、血流分级为Ⅱ~Ⅲ级、长短径之比大于1.51时,应考虑可能为WT。Objective:To evaluate the clinical value of ultrasonography in the differential diagnosis of pleomorphic adenoma and Warthin tumor(WT)in parotid gland.Methods:Forty-five pleomorphic adenomas and seventy-one WT were confirmed by surgical histopathology after the ultrasonography process.And the parameters including gender,age,multifocality,maximum diameter,minimum diameter,maximum and minimum diameter ratio,shape,margin,echogenicity,heterogeneity,cystic degeneration,reticular cord,calcification,posterior echogenicity and grades of vascularity were retrospectively compared between the groups mentioned above.The receiver operating characteristic(ROC)curve was also plotted to analyze the diagnostic efficacy of ultrasonic indicators of WT in parotid gland.Results:Gender,age,multifocality,maximum diameter,maximum and minimum diameter ratio,shape,echogenicity,heterogeneity,cystic degeneration,reticular cord,posterior echogenicity and grades of vascularity were the significant factors for differentiating WT from pleomorphic adenoma.Three ultrasonic features with high value of differential diagnosis filtrated according to the area under curve(AUC)were reticular cord,grades of vascularity and maximum and minimum diameter ratio.The sensitivity and specificity of reticular cord in differentiation of WT from pleomorphic adenoma were 68.49%and 95.56%.The AUC was 0.820.The sensitivity and specificity of grades of vascularity were 76.56%and 71.43%.The AUC was 0.740.When the cutoff value was 1.51,the sensitivity and specificity of maximum and minimum diameter ratio were 65.80%and 80.00%.The AUC was 0.708.Conclusion:There are significant differences in ultrasonic features between pleomorphic adenoma and WT.Reticular cord,gradesⅡ-Ⅲof vascularity and the maximum and minimum diameter ratio greater than 1.51 are important characteristics of WT.

关 键 词：腮腺肿瘤 沃辛瘤 多形性腺瘤 超声 诊断 

分 类 号：R739.87[医药卫生—肿瘤] R445.1[医药卫生—临床医学]