超声灰度直方图对多形性腺瘤与腺淋巴瘤鉴别诊断效能的初步研究

Value research on differential diagnosis of pleomorphic adenomas and adenolymphoma by histogram analysis of ultrasound gray

目的探讨超声灰度直方图对腮腺多形性腺瘤与腺淋巴瘤的鉴别诊断价值。方法对18例多形性腺瘤(PA)与13例腺淋巴瘤(AL)患者的术前超声图像进行灰度直方图分析,比较PA与AL组患者直方图的均值、方差、偏度、峰度及第1、10、50、90、99百分位数的差异。应用受试者工作特征(ROC)曲线计算各参数的鉴别诊断效能。结果 PA组的方差高于AL组,偏度和峰度值低于AL组,其差异具有统计学意义(P<0.05);但2组的均值、第1、10、50、90及99百分位数的差异均无统计学意义(P>0.05)。ROC曲线分析显示,峰度值最具鉴别诊断效能,曲线下面积(AUC)为0.744 (P=0.022),最佳临界值为1.71,敏感度为76.9%,特异度为61.1%,约登指数为0.380。方差的鉴别诊断效能、最佳临界值、敏感度、特异度及约登指数分别为0.735 (P=0.028)、864.94、72.2%、76.9%及0.491。结论超声灰度直方图对PA与AL具有一定的鉴别诊断价值。

Objective To investigate the value of gray-scale histogram in the differential diagnosis of pleomorphic Adenoma and Adenolymphoma of parotid gland.Methods The preoperative ultrasound images of 18 patients with pleomorphic Adenoma(PA),and 13 patients with Adenolymphoma(AL) were analyzed for imaging gray-scale histograms parameters(mean,variance,skewness,Kurtosis,1 st,10 th,50 th,90 th,99 th percentiles).The Receiver Operating Characteristic(ROC) curve was used to calculate the differential diagnostic efficiency of each parameter.Results The variance of PA group was higher than that of AL group,but the skewness and kurtosis were lower than that of AL group,and the difference was statistically significant(P<0.05).The value of mean,the 1 st,10 th,50 th,90 th and 99 th percentiles between the two group had no significant difference(P>0.05).The analysis of ROC curve showed that the Kurtosis was the most effective parameter for differential diagnosis.The AUC was 0.744(P=0.022),the best critical value was1.71,the sensitivity was 76.9%,the specificity was 61.1%,and the yoden index was 0.380.Besides,The AUC,optimal critical value,sensitivity,specificity and Yoden index of variance were 0.735(P=0.028),864.94,72.2%,76.9% and0.491 respectively.Conclusion The ultrasonic gray histogram has a certain value in the differential diagnosis between PA and Al.