三维超微血管成像测量的血管指数鉴别诊断腮腺多形性腺瘤与Warthin瘤的价值探讨  

Value of the vascular index measured by three-dimensional superb microvascular imaging in the differential diagnosis of parotid pleomorphic adenoma and Warthin tumor

作　　者：陈明明 江姝 张剑[1] 卢叶君[1] 张津楠 邢伟[3] CHEN Mingming;JIANG Shu;ZHANG Jian;LU Yejun;ZHANG Jinnan;XING Wei(Department of Ultrasound Medicine,Changzhou First People’s Hospital,the Third Affiliated Hospital of Soochow University,Jiangsu 213003,China)

机构地区：[1]苏州大学附属第三医院常州市第一人民医院超声医学科,江苏省常州市213003 [2]苏州大学附属第三医院常州市第一人民医院心功能科,江苏省常州市213003 [3]苏州大学附属第三医院常州市第一人民医院影像科,江苏省常州市213003

出　　处：《临床超声医学杂志》2024年第8期656-661,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用三维超微血管成像(3D-SMI)测量腮腺多形性腺瘤(PA)与Warthin瘤的血管指数(VI),探讨其在二者鉴别诊断中的价值。方法选取我院经手术病理证实的腮腺肿瘤患者88例,其中PA 51例,Warthin瘤37例,均行CDFI、二维超微血管成像(2D-SMI)、3D-SMI、超声造影(CEUS)检查,比较PA与Warthin瘤上述超声图像特征及定量参数的差异。分别建立基于CDFI参数、2D-SMI参数、CEUS参数鉴别诊断PA与Warthin瘤的回归模型;绘制受试者工作特征(ROC)曲线分析VI、CDFI模型、2D-SMI模型、CEUS模型鉴别PA与Warthin瘤的诊断效能。结果PA与Warthin瘤CDFI和2D-SMI血流方式及血流分级比较差异均有统计学意义(均P<0.001)。PA与Warthin瘤CEUS增强程度、是否均匀增强、峰值强度、峰值减半时间、120 s强度、曲线下面积、半下降斜率比较差异均有统计学意义(均P<0.05)。ROC曲线分析显示,VI、CDFI模型、2D-SMI模型、CEUS模型鉴别诊断PA与Warthin瘤的曲线下面积分别为0.924、0.750、0.806及0.883,其中VI与CDFI模型、2D-SMI模型的曲线下面积比较差异均有统计学意义(均P<0.05),VI与CEUS模型的曲线下面积比较差异无统计学意义。结论3D-SMI测量的VI在鉴别诊断腮腺PA与Warthin瘤中有一定价值,其诊断效能与CEUS相当,且显著优于2D-SMI和CDFI。Objective To explore the value of vascular index(VI)measured by three-dimensional superb microvascular imaging(3D-SMI)in the differential diagnosis of parotid pleomorphic adenoma(PA)and Warthin tumor.Methods A total of 88 patients with parotid gland tumor confirmed by surgery and pathology in our hospital were selected,including 51 patients with PA and 37 patients with Warthin tumor,all patients were examined by CDFI,two-dimensional superb microvascular imaging(2D-SMI),3D-SMI and contrast-enhanced ultrasound(CEUS).The differences of the above ultrasonic image features and quantitative parameters between PA and Warthin tumor were compared.The regression models were established based on CDFI parameters,2D-SMI parameters and CEUS parameters for the differential diagnosis of PA and Warthin tumors.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiency of VI,CDFI model,2D-SMI model and CEUS model in distinguishing PA from Warthin tumor.Results There were significant differences in vascular distribution type and blood flow grading of CDFI and 2D-SMI between PA and Warthin tumors(both P<0.001).There were statistically significant differences in enhancement degree,uniform enhancement,peak intensity,half time to descent,120 s intensity,area under the cure and semi-descent slope between PA and Warthin tumors(all P<0.05).ROC curve analysis showed that the area under the curve of VI,CDFI model,2D-SMI model and CEUS model in distinguishing PA from Warthin tumors were 0.924,0.750,0.806 and 0.883,respectively.There were statistically significant differences in the area under the curve between VI and CDFI model and 2D-SMI model(both P<0.05),while there was no statistically significant differences in the area under the curve between VI and CEUS model.Conclusion VI measured by 3D-SMI has certain clinical value in the differential diagnosis of parotid PA and Warthin tumor,and its diagnostic efficiency is comparable to CEUS,and significantly better than 2D-SMI and CDFI.

关 键 词：超声检查 造影剂 超微血管成像 三维 二维 血管指数 腮腺多形性腺瘤 WARTHIN瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学]