超声造影与磁共振联合在腮腺肿瘤诊断中的临床价值  

Clinical value of contrast-enhanced ultrasound combined with magnetic resonance imaging in the diagnosis of parotid gland tumors

作　　者：王宪 王培 陈晶莹 刘爱绒 卫媛 陈颖 郭军 WANG Xian;WANG Pei;CHEN Jingying;LIU Airong;WEI Yuan;CHEN Ying;GUO Jun(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Clinical Research Center for Oral Diseases,Department of Imaging Medicine,The Third Affiliated Hospital of Air Force Medical University,China,710032 Xi'an)

机构地区：[1]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,空军军医大学第三附属医院影像医学科,西安710032

出　　处：《实用口腔医学杂志》2025年第1期75-79,共5页Journal of Practical Stomatology

基　　金：空军军医大学第三附属医院新技术新业务面上项目(编号:LX2021-318)。

摘　　要：目的:探讨超声造影(CEUS)与磁共振成像(MRI)联合在腮腺肿瘤诊断中的临床价值。方法:纳入腮腺肿瘤患者167例,入院后均行CEUS与MRI检查,以术后病理结果为金标准,分析CEUS与MRI联合的诊断价值。结果:167例患者经术后病理证实为共171个肿瘤,其中良性有143个(83.63%),恶性有28个(16.37%),良性肿瘤中以多形性腺瘤(65个,45.45%)、沃辛瘤(40个,27.97%)、基底细胞腺瘤(13个,9.09%)为主;恶性肿瘤中以黏液表皮样癌(7个,25.00%)、腺样囊性癌(6个,21.43%)、腺泡细胞癌(3个,10.71%)为主。CEUS检查显示39例为恶性腮腺肿瘤,132例为良性腮腺肿瘤,CEUS诊断的敏感性、特异性及准确率分别为57.14%、83.92%、79.53%。MRI检查的ADC值为多形性腺瘤>恶性肿瘤>沃辛瘤(P<0.05)。MRI检查显示53例为恶性腮腺肿瘤,118例为良性腮腺肿瘤,MRI诊断的敏感性、特异性及准确率分别为67.86%、76.22%、74.85%。CEUS+MRI检查显示33例为恶性腮腺肿瘤,138例为良性腮腺肿瘤,CEUS+MRI诊断的敏感性、特异性及准确率分别为78.57%、92.31%、90.06%,且特异性和准确率明显高于单一检查(χ^(2)=4.806、13.951、7.348、13.664,P均<0.05)。结论:CEUS和MRI对腮腺肿瘤的诊断均有一定临床价值,且两者联合的特异性和准确率明显高于单一检查。Objective:To explore the clinical value of combination of contrast-enhanced ultrasound(CEUS)and magnetic resonance imaging(MRI)in the diagnosis of parotid gland tumors.Methods:167 patients with parotid gland tumors were diagnosed by CEUS and MRI respectively and in combination.With postoperative pathological diagnosis result as the gold standard,the diagnostic value of CEUS combined with MRI(CEUS+MRI)was analyzed.Results:171 tumors were confirmed by postoperative pathology in 167 patients,including 143 benign tumors(83.63%)and 28 malignant tumors(16.37%).The benign tumors were mainly pleomorphic adenoma(65 tumors,45.45%),Warthin tumor(40 tumors,27.97%)and basal cell adenoma(13 tumors,9.09%).Among the malignant tumors,mucoepidermoid carcinoma(7 tumors,25.00%),adenoid cystic carcinoma(6 tumors,21.43%)and acinic cell carcinoma(3 tumors,10.71%)were the most common.CEUS showed 39 cases of malignant parotid gland tumors and 132 cases of benign parotid gland tumors.The sensitivity,specificity and accuracy rate of CEUS were 57.14%,83.92%and 79.53%respectively.The MRI ADC values were manifested as pleomorphic adenoma>malignant tumor>Warthin tumor(P<0.05).MRI showed 53 cases of malignant parotid gland tumors and 118 cases of benign parotid gland tumors,and the sensitivity,specificity and accuracy rate of MRI diagnosis were 67.86%,76.22%and 74.85%respectively.CEUS+MRI revealed 33 cases of malignant parotid gland tumors and 138 cases of benign parotid gland tumors,the sensitivity,specificity and accuracy rate of CEUS+MRI diagnosis were 78.57%,92.31%and 90.06%respectively.The specificity and accuracy rate of CEUS+MRI were significantly higher than those of single examination(χ^(2)=4.806,13.951,7.348,13.664,all P<0.05).Conclusion:Both CEUS and MRI have certain clinical value in the diagnosis of parotid gland tumors,and the specificity and accuracy rate of CEUS+MRI are significantly higher than those of single examination.

关 键 词：超声造影 磁共振成像 腮腺肿瘤 诊断 临床价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.8[医药卫生—诊断学]