高频超声诊断在腮腺肿瘤诊断中的价值及误诊原因分析

目的:探讨高频超声诊断在腮腺肿瘤诊断中的价值及分析其误诊的原因，以期提高高频超声诊断腮腺肿瘤的符合率。方法:回顾性分析经手术及病理证实的12例腮腺多形性腺瘤病例、10例Warthin瘤病例的高频超声特点，分析并观察肿块的大小、形态、性质、解剖部位、内部回声，应用彩色多普勒检测肿块内部血流的丰富程度。结果:高频超声诊断12例腮腺多形性腺瘤患者中，诊断为多形性腺瘤6例，正确诊断率为50%，误诊为淋巴结炎2例，误诊为血肿1例，诊断为混合性占位、性质待定3例，误诊率50%。应用高频超声诊断10例Warthin瘤患者时，诊断为Warthin瘤4例，正确诊断率为40%，误诊为多形性腺瘤3例，误诊为淋巴结炎1例，诊断为混合性占位、性质待定2例，误诊率60%。多形性腺瘤与Warthin瘤的回声强度无差异，P>0.05；后壁回声增强、血流信号强度分级有差异，P<0.05，差异有统计学意义。结论:典型的多形性腺瘤、Warthin瘤有各自的声像图特点，非典型的多形性腺瘤类似于Warthin瘤。高频超声检查在腮腺多形性腺瘤与Warthin瘤的鉴别诊断过程中，有较高应用价值。通过观察肿块的形态、边界、包膜、内部回声、后壁回声增强情况，并运用彩色多普勒检查检测内部血流情况，结合患者一般临床资料，可以提高腮腺多形性腺瘤与Warthin瘤的诊断准确率。

High frequency ultrasound diagnosis and misdiagnosis in the diagnosis of parotid gland tumors

Objective:To evaluate the diagnostic value of high frequency ultrasound in the diagnosis of parotid gland tumors and analyze the causes of misdiagnosis，in order to improve the high-frequency ultrasound diagnosis of parotid gland tumors compliance rate.Methods:A retrospective analysis by surgery and pathology confirmed 12 cases of pleomorphic adenoma cases，high-frequency ultrasound features of 10 cases of Warthin tumors were analyzed and tumor size，shape，nature，anatomic site，internal echo were observed.Color Doppler was applied to detect blood flow inside the tumor.Results:In 12 cases of high-frequency ultrasound diagnosis of parotid pleomorphic adenoma patients，the diagnosis of pleomorphic adenoma had six cases，and the correct diagnosis was about 50%.Two cases were misdiagnosed as lymphadenitis，one case was misdiagnosed as hematoma，three cases diagnosed as mixed placeholder，and the misdiagnosis rate was 50%.In the application of high frequency ultrasound diagnosis of 10 cases of Warthin tumors,four cases were diagnosed as Warthin tumor，the correct diagnosis was about 40%，Three cases were misdiagnosed as pleomorphic adenoma，one case was misdiagnosed as lymphadenitis，two cases with mixed occupancy，the misdiagnosis rate was 60%.Echo intensity between pleomorphic adenoma and Warthin tumors had no difference，P>0.05，but posterior echo enhancement，blood flow signal intensity grade had differences，P<0.05.Conclusion:The typical pleomorphic adenoma，Warthin tumors have their sonographic features.Atypical pleomorphic adenoma is similar with Warthin tumor.High frequency ultrasound in the pleomorphic adenoma and Warthin tumor has a higher value.Morphology observed by mass，borders，capsule，internal echo，posterior echogenic situation and the use of color Doppler blood flow inside the case，combined with patient clinical data can improve the diagnostic accuracy of pleomorphic adenoma and Warthin tumor.