多模态超声对唾液腺肿瘤的鉴别诊断价值评价

Analysis of multimodal ultrasound in differential diagnosis of salivary gland tumors

目的:探讨多模态超声对唾液腺良、恶性肿瘤的鉴别诊断价值,对有意义的参数进行赋值后,初步建立评分系统。方法:对69例唾液腺肿瘤患者的77个肿瘤进行二维灰阶超声、彩色多普勒超声(CDFI)、超微血流成像(SMI)、实时组织弹性成像(RTE)及声脉冲辐射力成像(ARFI)检查,对有意义的参数赋值及组合得到不同评分方案,绘制各方案ROC曲线,将曲线下面积最大者作为最佳评分方案。采用SPSS 25.0软件包对数据进行统计学分析。结果:肿瘤形态、边界、后方回声、血流阻力指数、RTE分级和ARFI平均值在唾液腺肿瘤良、恶性鉴别中具有统计学差异(P<0.05)。由以上6个参数组成的评分方案7为最佳评分方案,每个参数赋值1分,总分为6分,曲线下面积为0.944,以≥4分鉴别唾液腺肿瘤良恶性的敏感度、特异度、准确率分别为80.0%、98.4%和94.8%。结论:多模态超声的应用及评分系统的建立,可有效提高超声对唾液腺肿瘤鉴别诊断的能力。

PURPOSE:To explore the differential diagnosis of salivary gland tumors by multimodal ultrasound and to establish a preliminary scoring system by assigning meaningful parameters.METHODS:Seventy-seven tumors from 69 patients with salivary gland tumors were examined by two-dimensional gray-scale ultrasound,color Doppler flow imaging(CDFI),superb microvascular imaging(SMI),real time tissue elastography(RTE)and acoustic radiation force impulse(ARFI).Different scoring schemes were obtained for the assignment and combination of meaningful parameters.The ROC curve of each scheme was drawn,and the one with the largest area under the curve was taken as the best scoring scheme.SPSS 25.0 software package was used for statistical analysis of the data.RESULTS:There were significant differences in tumor shape,boundary,posterior echo,blood flow resistance index,RTE grade and ARFI average value between benign and malignant salivary gland tumors(P<0.05).The scoring scheme 7,which was composed of the above 6 parameters,was the best scoring scheme.When each parameter was assigned a score of 1,the total score was 6,and the area under the curve was 0.944.The sensitivity,specificity and accuracy of distinguishing benign and malignant salivary gland tumors with≥4 points were 80.0%,98.4%and 94.8%,respectively.CONCLUSIONS:Application of multimodal ultrasound and establishment of a scoring system can effectively improve the ability of ultrasound in the differential diagnosis of benign and malignant salivary gland tumors.