腮腺混合瘤的超声诊断及其价值

目的：探讨腮腺混合瘤的声像图特征及其临床价值。方法：应用彩色多普勒超声对22例经病理证实的腮腺混合瘤进行观察。结果：实性不均匀12例，实性4例，囊实性5例，囊性1例。彩色多普勒显示：8例表现为0级血流信号，14例表现为Ⅰ级--Ⅲ级血流信号。结论：腮腺混合瘤有显著的声像图特点，彩色多普勒超声有助于提高诊断的正确性。     

高频彩超检查对腮腺肿块的诊断价值

目的评价高频彩超检查对腮腺肿块的诊断及鉴别诊断的价值。方法应用高频彩超对58例腮腺肿块的患者进行检查,并结合病理检查结果分析、总结腮腺肿块的超声图像特征。结果高频彩超检查对腮腺肿块的总检出率为100％,对腮腺良、恶性肿块的诊断符合率分别为87．2％、68．4％,其中腮腺囊肿诊断符合率为100％。二维超声检查中腮腺良、恶性肿块在形态、边界、边缘和内部回声方面的差异均有统计学意义（P〈0．05）。彩色多普勒血流显像对腮腺良、恶性肿块血流信号的检出率分别为82．1％、94．7％。以收缩期峰值流速≥23．8cm／s作为诊断腮腺恶性肿块阈值的标准,脉冲多普勒诊断的敏感度和特异度分别为73．7％和71．8％;以阻力指数≥0．68（除混合瘤外）作为诊断腮腺恶性肿块阈值的标准,其诊断敏感度和特异度分别为73．3％和85．0％。结论高频彩超检查对腮腺肿块的检出率及诊断符合率均较高,对腮腺肿块的定性诊断有重要的临床应用价值。     

高频超声在睾丸肿瘤诊断中的应用

睾丸肿瘤占男性全身肿瘤的1%～2%,绝大多数为恶性[1].睾丸肿瘤较早即可发生转移,故早期发现并了解有无转移,对睾丸肿瘤的临床治疗有重要意义.我们对43例睾丸肿瘤的超声检查资料进行了回顾性分析,以探讨高频彩色多普勒超声对睾丸肿瘤诊断的应用价值.     

高频彩超在乳腺肿瘤鉴别诊断中的诊断价值

目的探讨高频彩超在乳腺肿瘤鉴别诊断中的价值。方法对140例乳腺肿瘤患者术前进行乳腺超声检查,结合术后病理结果对照分析乳腺肿瘤超声二维声像图、彩色多普勒(CDFI)和能量多普勒超声(PDUS)的诊断符合率。结果乳腺良性肿瘤诊断符合率为84.1%,恶性肿瘤诊断符合率为87.3%,彩色多普勒显示,恶性肿瘤的血流信号较良性的丰富,血流分级较良性高,差异有统计学意义(P<0.001)。能量多普勒显示,良恶性肿瘤病灶内的血管形态比较,差异有统计学意义(P<0.001)。结论高频彩超对乳腺肿瘤的检出率高,应用二维声像图特点与彩色多普勒和能量多普勒超声综合判断,可以明显提高对乳腺良恶性肿瘤的诊断和鉴别诊断水平。     

高频彩超血流显像和能量图在甲状腺肿瘤诊断中的应用

超声诊断技术在甲状腺肿瘤的术前检查和术后随访中的作用已得到临床肯定。彩色多普勒血流显像（ color doppler flow imaging,CDFI）和彩色多普勒能量图（ color doppler energy,CDE）是影像诊断领域近年开展的一项新技术,本研究旨在探讨 CDFI和 CDE在甲状腺肿瘤定性诊断中的价值。     

超微血流显像在甲状腺微小结节诊断中的应用价值分析

目的 研究超微血流显像(SMI)在甲状腺微小结节(TSN)诊断中的应用价值.方法 选择136例TSN患者,结节数目169个,先行二维超声及彩色多普勒超声检查,发现可疑结节后启动SMI、彩色多普勒血流显像(CDFI)模式进行诊断,比较SMI、CDFI诊断TSN良恶性的敏感度、特异度、阳性预测值、阴性预测值,以及SMI、CDFI模式下良恶性TSN的血流分级和血供分型.结果 经病理检查,169个结节中,恶性结节97个(57.40%),良性结节72个(42.60%).以病理检查结果为金标准,SMI诊断TSN良恶性的敏感度(92.78%)、特异度(95.83%)、阳性预测值(96.77%)、阴性预测值(90.79%)均高于CDFI诊断的敏感度(82.47%)、特异度(80.56%)、阳性预测值(85.11%)、阴性预测值(77.33%).SMI模式下良性TSN血流检出率(88.89%)高于CDFI模式(68.05%),恶性TSN血流检出率(52.58%)低于CDFI模式(71.13%),差异均有统计学意义(P﹤0.05).SMI、CDFI模式下良恶性TSN的血流分级和血供分型比较,差异均有统计学意义(P﹤0.05).结论 SMI可有效判断微小血管及低速血流,准确观察微细血管,敏感度、特异度及血流检出率均较高,在TSN良恶性的辅助诊断上具有较高的应用价值.     

彩色多普勒超声在甲状腺肿瘤诊断中的应用

目的：探讨彩色多普勒超声在甲状腺肿瘤诊断中的临床应用价值。方法回顾性分析46例经手术病理证实的甲状腺肿瘤患者的临床资料，包括彩色多普勒超声检查资料和手术病理资料等，分析彩色多普勒超声在甲状腺肿瘤诊断中应用情况。结果甲状腺恶性肿瘤患者的声像图主要表现为不均质、沙粒状钙化等，甲状腺良性肿瘤患者的声像图主要表现为囊肿壁钙化、囊性变、后方增强等。彩色多普勒超声诊断甲状腺肿瘤的总体诊断符合率较高，甲状腺腺瘤最高，为88.2％，然后依次为结节性甲状腺肿、甲状腺囊肿、甲状腺癌，分别为83.3％、83.3％、80.0％。结论彩色多普勒超声具有无创、无辐射、可重复的优势，作为甲状腺肿瘤的诊断与鉴别诊断首选手段值得推广。     

高频超声诊断腮腺混合瘤的价值

超声检查腮腺始于1972年,以闭式水囊机械线扫方式进行。随着临床实践的积累,诊断仪器的进步和新技术、新方法的应用,超声已成为腮腺疾病检查的首选影像诊断手段。我们通过高频超声检查腮腺,探讨其在临床中的应用价值。     

腮腺多形性腺瘤与沃辛瘤MRI影像学特点的对比分析

多形性腺瘤和沃辛瘤是腮腺最常见的两种良性肿瘤。发生于腮腺的多形性腺瘤MRI平扫T1WI表现为等或稍低信号,T2WI表现为高信号,因含黏液其信号高于脑脊液;如发生坏死、囊变,T2WI表现为高低混杂信号;肿瘤有纤维包膜,T1WI和T2WI均表现为低信号,与正常组织分界清楚。沃辛瘤（腺淋巴瘤）内上皮成分嗜酸性并具有淋巴组织及密集排列的细胞核,故T2WI多以低信号为主,且信号均匀居多,可作为与混合瘤的鉴别点。本文研究发现腮腺多形性腺瘤与沃辛瘤在MRI成像上有不同的影像学特点,期望对临床工作有所帮助。     

A retrospective study of parotid gland tumors at a single institution

The aim of the present study was to analyze the clinical characteristics, surgical treatments and clinical outcome of patients with parotid gland tumors and to compare the results with those cited in the literature. A retrospective study was conducted in 140 patients (male, n=77; female, n=63) with parotid gland tumors who underwent parotidectomy at Hokuto Hospital Department of Otolaryngology-Head and Neck Surgery (Obihiro, Japan) between April 2007 and December 2021. Of the 140 patients enrolled, 118 (84.3%) patients had benign tumors, including 63 (45%) patients with pleomorphic adenomas and 43 (30.7%) patients with Warthin tumors, and 22 patients (15.7%) had parotid carcinoma. Comparison of the three groups of patients with parotid gland tumors indicated that pack years as an indicator of smoking status were significantly higher in patients with Warthin tumors than in those with parotid carcinomas (P=0.011) or pleomorphic adenoma (P<0.001). Fine-needle aspiration cytology (FNAC) was non-diagnostic for only 6 (4.3%) of 140 patients. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC by both conventional smear and liquid-based cytology (LBC) for parotid carcinomas were 70, 99, 93.3, 94.4 and 82.9%, respectively. Among the 22 patients with parotid carcinoma, extended total/total and superficial parotidectomy were performed in 10 (45%) and 11 (50%) cases, respectively. Total and selective neck dissection of the area from level II to I, II and III were performed in 6 (24%) and 7 (32%) patients, respectively. Postoperative radiotherapy (50 Gy) was performed in 15 (68%) patients. The overall survival (OS) and disease-free survival (DFS) rates at 5 years were 51.5 and 76.4%, respectively. Univariate analysis revealed that age >65 years was significantly associated with poorer 5-year OS (P<0.001) and DFS (P<0.001). Multivariate analysis revealed that an age of more than 65 years combined with high-grade histologic malignancy was associated with worse DFS (P=0.02; hazard ratio, 3.628; 95% confidence interval, 1.283-9.514). In conclusion, the clinical characteristics and treatment outcomes of parotid gland tumors were consistent with the results of previous reports. Smoking may be closely related to the pathogenesis of Warthin tumors. LBC potentially provides improved accuracy in FNAC.     

腮腺复发性多形性腺瘤临床诊治分析（附67例）

目的:研究腮腺复发性多形性腺瘤的临床特点,总结其手术治疗经验。方法:对2010年6月至2018年6月期间我院收治的67例腮腺复发性多形性腺瘤病例进行回顾性分析,总结其临床病理特征、手术方式、术后并发症及随访情况,使用SPSS 22.0软件对数据进行χ2检验、t检验、Logistic回归分析。结果:40例初次手术行腮腺区肿物切除术者,其平均复发时间短于27例行腮腺浅叶切除或浅叶部分切除者［（17.18±5.39）个月 vs （20.89±6.63）个月,P＜0.05］。复发性多形性腺瘤可出现皮肤粘连（40.3%）、面神经粘连（73.1%）、多灶性病变（56.7%）、肿瘤包膜不完整（92.5%）以及镜下卫星结节（79.3%）等特征。主要的远期并发症为永久性面神经损伤(n=9,13.4%)及Frey综合征(n=18,26.9%)。随访期间术后再次复发7例,复发率13.0%,术中出现肿瘤破裂者,术后复发率较高（31.8% vs 0%,P＜0.05）。结论:腮腺多形性腺瘤初次肿物摘除术后复发常见,复发性肿瘤局部病变广泛,术后并发症常见,外科治疗应个体化,以腮腺浅叶切除为主,根据病变情况及患者意愿决定是否切除深叶;术中肿瘤破裂将增加术后复发风险,应尽量避免,术后还需密切随访。     

影像组学在腮腺多形性腺瘤与腺淋巴瘤鉴别诊断中的应用

目的:探究影像组学在腮腺多形性腺瘤与腺淋巴瘤中的鉴别能力.方法:回顾性研究经病理诊断证实的52例多形性腺瘤与46例腺淋巴瘤患者CT平扫图像,利用MaZda纹理分析软件对肿瘤最大层面感兴趣区(ROI)进行分析,结合B11模块中的原始数据分析(RDA)、主成分分析(PCA)、线性判别分析(LDA)、非线性判别分析(NDA)...     

Oncocytic pleomorphic adenoma of the parotid gland

A rare case of salivary gland pleomorphic adenoma, in which the majority of cells were oncocytic, is reported. The patient, a 53-year-old man, presented with a parotid gland mass that was otherwise asymptomatic. Surgical treatment consisted of a superficial parotid lobectomy. The specimen was prepared in standard fashion and studied by light and electron microscopy. The microscopic features were characteristic of salivary gland pleomorphic adenomas, however, both epithelial and "mesenchymal" elements were oncocytic. Such changes may occur focally in pleomorphic adenomas, but we were unable to find documentation of a wholly oncocytic variant in a review of the medical literature. From our clinical data and previous reports of pleomorphic adenomas with focal oncocytosis, it is concluded that such changes likely do not alter prognosis in affected patients. The possible significance of this lesion in regard to the histogenesis of salivary gland pleomorphic adenomas is discussed.     

The role of immune surveillance in malignant transformation of benign salivary gland tumors

Pleomorphic adenoma (PA), the most common salivary gland tumor, is a benign tumor that carries a risk of malignant transformation to various histologies of carcinoma ex pleomorphic adenoma (CA exPA). Recently, genomic analyses have provided deeper insights into the molecular biology of salivary gland cancers. However, the molecular processes that underlie the progression from PA to CA exPA are largely unknown. In this study, we used RNAseq data from CA ex PA of myoepithelial (n = 24) or salivary duct histology (n = 6), de novo myoepithelial carcinoma (n = 16) and de novo salivary duct carcinoma (n = 10), and compared their constituent immune tumor microenvironments. We found that increasing levels of immune infiltration and activation were associated with a generally lower probability of cancer developing ex-PA, suggesting that immune surveillance may constrain the malignant transformation of benign salivary tumors. More immunologically infiltrated tumors were more likely to have developed de novo. Taken together, these data suggest a role for tumor escape from immune surveillance in the development of CA exPA. The immune-cold microenvironments of CA ex PA tumors may in part explain their more aggressive clinical behavior.     

血液源性原发脊柱肿瘤诊断及治疗的研究进展

血液源性原发性脊柱肿瘤在临床上相对少见,其主要分为骨髓瘤来源和淋巴瘤来源,均可发生于脊柱,由于其影像学表现多样,早期临床表现不典型,血液源性原发脊柱肿瘤诊断及治疗相对滞后。本文就脊柱多发性骨髓瘤、孤立性浆细胞瘤以及脊柱原发性非霍奇金淋巴瘤目前的诊断及治疗进行总结综述。