涎腺混合瘤与Warthin瘤超声造影对比研究

Contrast-enhanced ultrasonic manifestations of salivary gland pleomorphic adenomas and Warthin tumors:a comparative study

目的总结涎腺混合瘤与Warthin瘤的超声造影特征,分析二者的差异。方法回顾性分析我院经手术病理证实的17个涎腺混合瘤和16个Warthin瘤的超声造影特征。结果混合瘤超声造影表现以同进(76.5%)、向心性(64.7%)、不均匀性(76.5%)、低增强(70.6%)为主,增强后边界多清晰(88.2%),大部分可见增强环(94.1%),增强后肿块范围多不增大(88.2%)。Warthin瘤超声造影表现以快进(50.0%)、非向心性(87.5%)、不均匀性(62.5%)、高增强(56.3%)多见,大部分增强后边界清晰、可见增强环和增强后肿块范围不增大(均为93.8%)。涎腺混合瘤与Warthin瘤的增强方向和增强强度比较差异均有统计学意义(均P<0.05)。以非向心性增强诊断Warthin瘤的敏感性、特异性和准确率分别为87.5%、64.7%、75.8%;以高增强诊断Warthin瘤的敏感性、特异性和准确率分别为56.3%、100%、78.8%。以向心性增强诊断涎腺混合瘤的敏感性、特异性和准确率分别为64.7%、87.5%、75.8%;以低增强诊断涎腺混合瘤的敏感性、特异性和准确率分别为70.6%、87.5%、84.9%。结论涎腺混合瘤与Warthin瘤的超声造影表现具有一定的特征性,增强方向和增强强度指标有助于二者的鉴别诊断。

Objective To summarize the contrast-enhanced ultrasonic characteristics of pleomorphic adenomas and Warthin tumors of salivary gland.Methods Seventeen patients with pleomorphic adenomas and 16 patients with Warthin tumors underwent contrast-enhanced ultrasound examination and confirmed by surgical histopathology were retrospectively analyzed.Results The contrast-enhanced ultrasonic characteristics of pleomorphic adenomas were mainly synchronal(76.5%),centripetal(64.7%),inhomogeneity(76.5%)and hypo-enhancement(70.6%),with clear boundary after enhancement(88.2%),visible enhancement rim(94.1%),and no increase in the mass scope after enhancement(88.2%).The ultrasonic characteristics of Warthin tumors were fast fill-in(50.0%),non-centrality(87.5%),inhomogeneity(62.5%),and hyper-enhancement(56.3%).After enhancement,the boundary was clear,the enhancement rim was visible,and the mass scope was not increased(93.8%).There were statistically significant differences in the enhancement direction and enhancement intensity between pleomorphic adenomas and Warthin tumors(both P<0.05).The sensitivity,specificity and accuracy were 87.5%,64.7%,75.8%in the diagnosis of Warthin tumor by noncentric enhancement.The sensitivity,specificity and accuracy were 56.3%,100%,78.8%in the diagnosis of Warthin tumor by hyper-enhancement.The sensitivity,specificity and accuracy were 64.7%,87.5%,75.8%in the diagnosis of pleomorphic adenomas by centripetal enhancement.The sensitivity,specificity and accuracy were 70.6%,87.5%and 84.9%in the diagnosis of pleomorphic adenomas by hypo-enhancement.Conclusion The contrast-enhanced ultrasonic characteristics of pleomorphic adenomas and Warthin tumors have certain characteristics,and the enhancement direction and enhancement intensity parameters are helpful to differentially diagnose pleomorphic adenomas and Warthin tumors.