超声鉴别诊断涎腺肿瘤良恶性的特征分析

目的探讨超声鉴别诊断涎腺肿瘤良恶性的临床价值。方法回顾性分析我院经手术病理证实的121例诞腺肿瘤患者(124个病灶,良性111个,恶性13个)的超声资料,比较良恶性病灶最大径、纵横比、病灶数、回声均匀性、形态、边界、后方回声、囊性变、钙化灶及血流分级等指标;绘制受试者工作特征(ROC)曲线分析特征性超声指标预测肿瘤良恶性的诊断效能。结果良恶性病灶最大径、纵横比、病灶数、回声均匀性、形态、后方回声、囊性变及血流分级等指标比较差异均无统计学意义;仅边界和钙化灶方面比较差异均有统计学意义(均P<0.05)。边界指标诊断恶性肿瘤敏感性46.15%,特异性95.50%,准确率90.32%,曲线下面积为0.708;钙化灶指标诊断恶性肿瘤敏感性30.77%,特异性72.97%,准确率68.55%,曲线下面积为0.640。结论仅根据常规超声单一特征鉴别诊断涎腺肿瘤良恶性较为困难,当肿瘤出现边界不清和内部多发钙化灶时应考虑恶性可能。

Analysis on characteristics of ultrasonography in the differential diagnosis of benign and malignant salivary gland tumors

Objective To evaluate the clinical value of ultrasonography in the differential diagnosis of benign and malignant salivary gland tumors.Methods Ultrasound image data of 121 patients with salivary gland tumors were analyzed retrospectively,including 111 benign and 13 malignant,confirmed by post-surgical histopathology.Parameters including maximum diameter,height/width ratio,number of lesions,echogenicity,shape,margin,posterior echogenicity,cystic degeneration,calcification and grades of vascularity between benign and malignant tumors were collected and compared.The receiver operating characteristic(ROC)curve was plotted to calculate the diagnostic efficacy by these parameters.Results There were no statistically significant differences in maximum diameter,height/width ratio,number of lesions,echogenicity,shape,posterior echogenicity,cystic degeneration and grades of vascularity between benign and malignant tumors.Parameters of margin and calcification between benign and malignant tumors were significantly different(both P<0.05).The sensitivity,specificity,and accuracy of unclear margin in differentiation of malignant from benign neoplasms in the salivary gland were 46.15%,95.50%,and 90.32%,respectively.The area under the curve was 0.708.The sensitivity,specificity,and accuracy of calcification in differentiation of malignant were 30.77%,72.97%,68.55%,respectively.The area under the curve was 0.640.Conclusion It is difficult to differentiate benign and malignat salivary gland tumors according to a single feature of ultrasound image.Unclear borders and multiple internal calcifications are important features for differential diagnosis of salivary gland tumors.