高频彩色多普勒超声在腮腺多形性腺瘤诊断中的应用及其病理学对照研究

目的探讨腮腺多形性腺瘤的超声表现与病理组织学类型的关系.方法术前应用高频探头对38例腮腺多形性腺瘤患者行彩色多普勒超声检查,观察肿块大小、形态、边界、内部回声、毗邻关系、有无后方衰减及侧方声影等超声表现,并与病理组织学对照,分析肿块的超声表现与病理组织学分型的相关性.结果病理诊断上皮成分为主型多形性腺瘤20例,超声表现为肿块呈中等回声或低回声,分布尚均匀;黏液样为主型多形性腺瘤7例,超声表现为肿块内部有多处大小不等的囊性无回声区,黏液成分越多,无回声区越明显;混合型多形性腺瘤11例,镜下见上皮与黏液样成分相间,超声表现为肿块内部回声不均,为囊实混合性;肿块可纵向生长,形状呈分叶状或不规则形,且可突破包膜,肿块内有钙化斑且血流异常丰富者不能除外恶变可能.结论腮腺多形性腺瘤超声表现各异,与其组织学多形性密切相关,超声图像有一定特异性,可作出较准确的诊断,结合彩色多普勒血流特点,有可能提示恶变倾向.

High-frequency color Doppler ultrasound features in parotid pleomorphic adenoma: comparison with histopathology

] Objective The aim of the study was to define ultrasonographic morphologic features of parotid pleomorphic adenoma and to explore the relationship between ultrasonography and histopathology. Methods Ultrasonography was performed in 38 patients with parotid pleomorphic adenomas and the features and measurement data were analysed. All cases were confirmed by operation and histopathological examination. High-frequency color Doppler ultrasound was used to observe the borders, shapes, echogenicity, structures, irregular anechoic areas etc within a tumor. Results The major content was epithelial tissue in 20 cases (20/38) and ultrasonographic features were hypoechoic. The major content was mucous-like in 7 cases and mixed type was in 11 cases. Almost all cases were with irregular echo areas and 10 lumps of the pleomorphic adenoma were in irregular shape. Conclusions Ultrasonography is a useful method for the evaluation of parotid pleomorphic adenomas and the characteristics of the tumor is related to the histological types. In our opinion, ultrasound possesses definite characteristics for accurate diagnosis of the disease or to prompt malignant tendancy in certain situation.