三种常见良性唾液腺肿瘤的常规超声及临床特点  

Conventional Ultrasound and Clinical Characteristics of Three Common Benign Salivary Gland Tumors

作　　者：曹锦烨 丁昂昂 吕欢 陈倩倩[1] 周辉红[1] 张蔚倩 熊屏[1] Cao Jinye;Ding Ang'ang;Lyu Huan;Chen Qianqian;Zhou Huihong;Zhang Weiqian;Xiong Ping(Department of Ultrasound,Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院超声医学科,上海市200011

出　　处：《中国超声医学杂志》2024年第8期850-853,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金项目(No.81971618);上海市自然科学基金项目(No.23ZR1438000);上海交通大学医学院附属第九人民医院“交叉”研究基金项目(No.JYJC202132)。

摘　　要：目的 探究常规超声及临床特征对多形性腺瘤(PA)、沃辛瘤(WT)和基底细胞腺瘤(BCA)的诊断价值。方法 回顾性分析1 070例经病理确诊为PA、WT和BCA的患者,比较3组的临床特征和常规超声特征。基于多因素逻辑回归结果分析常规超声特征对PA、WT和BCA诊断的独立影响因素以及这些因素单独诊断和联合诊断的价值。结果 在临床特征上,PA好发于年轻女性,WT好发于老年男性,BCA好发于中年女性,WT多发比例明显高于PA和BCA。在超声特征上,分叶状或形态不规则、边界不清、内部回声不均、肿瘤最大径<23.5 mm以及少血供是PA的独立影响因素,联合诊断曲线下面积为0.810;形态规则、边界清、内部回声不均匀、肿瘤最大径>23.5 mm以及多血供是WT的独立影响因素,联合诊断曲线下面积为0.825;形态规则、内部回声均匀、肿瘤最大径<22.5 mm以及多血供是诊断BCA的独立影响因素,联合诊断曲线下面积为0.731。结论 常规超声以及临床特征对PA、WT和BCA的鉴别诊断具有重要意义,结合多个超声特征可提高对这些常见良性唾液腺肿瘤的诊断准确度。Objective This study is aimed to explore the diagnostic value of conventional ultrasound(US)and clinical features for pleomorphic adenoma(PA),Warthin tumor(WT),and basal cell adenoma(BCA).Methods We retrospectively analyzed 1070 patients who were diagnosed pathologically with PA,WT,and BCA and we analyzed the clinical and conventional US features among the three groups.Based on the results of multifactorial logistic regression analysis,we identified the independent factors influencing the diagnosis of PA,WT,and BCA with conventional US features.We also assessed the individual and combined value for diagnoses.Results In terms of clinical features,WT was more common in elderly males,PA in young females,and BCA in middle-aged females.The incidence of multiple lesions in WT was significantly higher than that in PA and BCA.Concerning US features,a lobulated or irregular shape,unclear margin,heterogeneous internal echo,tumor maximum diameter<23.5 mm,and reduced vascularity were independent factors for diagnosing PA,with a combined diagnostic area under the curve(AUC)of 0.810.For WT,regular shape,clear margin,heterogeneous internal echo,tumor maximum diameter>23.5 mm,and increased vascularity were independent factors,with a combined diagnostic AUC of o.825.For diagnosing BCA,regular shape,homogeneous internal echo,tumor maximum diameter<22.5 mm,and increased vascularity were independent factors,with a combined diagnostic AUC of o.731.Conclusions Conventional US and clinical features play a significant role in distinguishing PA,WT,and BCA,and combining multiple US features improves the accuracy of diagnosing these common benign salivary gland tumors.

关 键 词：常规超声 多形性腺瘤 沃辛瘤 基底细胞腺瘤 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.87[医药卫生—诊断学]