腮腺多形性腺瘤与腺淋巴瘤的超声、病理对照分析

Comparative analysis of ultrasound to pathology in parotid gland pleomorphic adenoma and adenolymophoma

目的通过对腮腺多形性腺瘤与腺淋巴瘤的超声、病理对照分析提高超声对两者的诊断准确率。方法回顾性分析经过病理证实的46个腮腺多形性腺瘤和60个腺淋巴瘤的超声图像特征。结果总共106个腮腺肿块超声表现均为低回声,边界多清楚,两者内部出现强回声灶的比例差异无统计学意义。多形性腺瘤和腺淋巴瘤的平均横纵径比值、浅分叶比例、出现无回声比例、病灶内出现0级和Ⅲ级血流信号的比例差异均有统计学意义(P<0.05)。上述超声特征与两者的病理成分有密切关系。手术病理显示:18%多形性腺瘤无包膜或包膜不完整,100%腺淋巴瘤均有包膜。前者18%出现囊性变,11%出现坏死,7%出现骨样物质;后者则有60%出现囊性变,未见有坏死及骨样物质。结论多形性腺瘤及腺淋巴瘤的声像图有一定特征,超声对鉴别两者有重要的实用价值。

Objective To promote the diagnostic accuracy of ultrasonography in pleomorphic adenoma and adenolymphoma according to analyze the features of ultrasonography contrasts to pathological results. Methods Ultrasound imagings of 46 pleomorphic adenomas and 60 adenolymphomas were analyzed retrospectively according to pathological features. Results All the masses were hypoechoic,well-defined,there was no stastistic differences of calcification ratio in both.There were significant differences of aspect rate,the ratio of lobulate mass,cystic change ratio,the ratio of grade 0 and Ⅲ blood signal between pleomorphic adenoma and adenolymphoma （P0.05）.These ultrasonographic characteristics had a close relationship with the pathological ingredients. Surgical histopathological features：18% pleomorphic adenomas had incomplete capsule or not,but all adenolymphomas had capsule. 18% of the former appeared cystic change,11% were observed with necrosis,7% with metaplastic bone formation; 60% of the latter appeared cystic change,no necrosis and no metaplastic bone formation. Conclusion Ultrasound is valuable for diagnosis of pleomorphic adenoma and adenolymphoma based on their ultrasonographic features.