唾液腺恶性肿瘤的超声征象及与病理类型关系

Sonographic appearances of malignant salivary gland tumors and the pathological classification

目的探讨唾液腺恶性肿瘤的超声征象与病理类型的关系。方法 25例肿瘤分低度恶性组9例、中高度恶性组16例。超声观察内容包括肿瘤大小、形态、边界、回声、血流、周围软组织及淋巴结。结果低度恶性组和中高度恶性组中:肿瘤最大径分别为(1.92±0.53)cm和(3.41±1.99)cm(t=-2.185,P<0.05);形态呈类圆或浅分叶、明显不规则形分别为66.7%(6/9)、33.3%(3/9)和18.8%(3/16)、81.3%(13/16),(χ2=5.740,P<0.05);低度恶性组边界清晰或欠清占66.7%(6/9),明显高于中高度恶性组25.0%(4/16),(χ2=4.167,P<0.05)。肿瘤呈均匀低回声者低度恶性组占66.7%(6/9),中高度恶性组37.5%(6/16),(χ2=1.963,P>0.05)。低度恶性组以无或少血流为主,中高度恶性组以多血流为主(χ2=2.707,P>0.05)。中高度恶性组有9例有软组织或淋巴结受侵犯,低度恶性组仅1例(χ2=4.890,P<0.05)。结论唾液腺恶性肿瘤的超声征象(形态、边界及周围受侵情况)与肿瘤的恶性程度有关。

OBJECTIVE To study the relationship of sonographic features and the pathological classification of malignant salivary gland tumors（MSGT）.METHODS Sonographic features of 25 patients with MSGTs were studied.There were 9 cases with low grade malignancy and 16 with moderate or high grade malignancy.The size,shape,border,echotexture,blood flow,adjacent soft tissue and lymph nodes were recorded.RESULTS The maximal size of low grade group and moderate or high grade group were（1.92±0.53）cm and（3.41±1.99）cm respectively（t=-2.185,P〈0.05）.Rounded or lobular type and irregular type in low grade group and moderate-high grade group was 66.7%（6/9）,33.3%（3/9）and 18.8%（3/16）,81.3%（13/16）respectively（χ^2=5.740,P〈0.05）.The well-border or partly well-border type was seen more often in low grade group than that in moderate or high grade group（66.7%, 25.0%, χ^2=4.167, P〈0.05）. The homogenous hypoecho type in two groups was 66.7%（6/9）and 37.5%（6/16） respectively（χ^2=1.963, P〈0.05）. The avascular or few vascular type was seen more often in low grade group, while the abundant vascular type was more often in moderate or high grade group（χ^2=2.707, P〈0.05）. Nine cases in moderate or high grade group had adjacent soft tissue or lymph nodes invaded, but only one case in low grade group（χ^2=4.890,P〈0.05）.CONCLUSION The sonographic appearances of malignant salivary gland tumors（shape,border,adjacent invasion）are related to pathologic grade.