MSCT双期增强鉴别腮腺多形性腺瘤与基底细胞腺瘤价值

Analysis of Clinical Value of MSCT Dual Phase Enhanced Scanning in Differential Diagnosis of Pleomorphic Adenoma and Basal Cell Adenoma of Parotid Gland

目的:对比分析腮腺多形性腺瘤与基底细胞腺瘤的MSCT征象,提高术前诊断准确性。方法:搜集我院2015年1月至2021年6月经手术病理证实的多形性腺瘤51例,基底细胞腺瘤26例病例资料,比较两组患者的年龄、性别及病灶位置、数目、最大径、密度及血管贴边征等征象,采用ROC曲线分析对比MSCT双期增强对两者鉴别诊断的临床价值。结果:腮腺多形性腺瘤与基底细胞腺瘤患者年龄及病灶最大径、密度及血管贴边征差异有统计学意义(P<0.05)。二者平扫、动脉期和静脉期CT值差异有统计学意义(P<0.05),平扫以41Hu为阈值,敏感度61.5%,特异度74.5%;动脉期以60.5Hu为阈值,敏感度88.5%,特异度72.5%;静脉期以97Hu为阈值,敏感度65.4%,特异度90.2%。MSCT双期增强模式:37例多形性腺瘤呈流入型,14例呈平台型;15例基底细胞腺瘤呈流入型,7例呈平台型,4例呈流出型。结论:MSCT动脉期CT值作为腮腺多形性腺瘤与基底细胞腺瘤的鉴别指标效能优于平扫与静脉期,MSCT双期增强特征结合临床资料,可为二者鉴别诊断提供可靠的依据。

Objective:To compare the multi-slice CT dual phase enhanced features of pleomorphic adenoma and basal cell adenoma of parotid gland, to improve the accuracy of preoperative diagnosis.Methods:51 cases pleomorphic adenoma and 26 cases basal cell adenoma of parotid gland confirmed by postoperative pathological in our hospital from January 2015 to June 2021 were retrospectively studied.The clinical data(age、sex),and MSCT features(location of lesions, number of lesions, tumor maximum diameter, density and vessel facing sign) of pleomorphic adenoma and basal cell adenoma were analyzed and compare;The diferential diagnosis value of MSCT dual phase enhancement in pleomorphic adenoma and basal cell adenoma was compared by ROC curve analysis.Results:There were statistically significant differences between pleomorphic adenoma of parotid gland and basal cell adenoma in age, lesion maximum diameter, density and vascular flanging sign(P<0.05). The CT values of plain scan, arterial phase and venous phase of between pleomorphic adenoma and basal cell adenoma were statistically significant differences(P<0.05). The CT values of plain scan with 41 Hu as the threshold value, the sensitivity and specificity were 61.5%,and 74.5%.The arterial phase with 61 Hu was used as the threshold value, the sensitivity and specificity were 88.5% and 72.5%;The venous phase with 97 Hu was used as the threshold value, the sensitivity and specificity were 65.4% and 90.2%.MSCT dual phase enhancement of 37 cases of polymorphic adenomas showed “inflow type”, 14 cases showed “plateau type”, 15 cases of basal cell adenoma showed “inflow type”, 7 cases showed “platform type”, and 4 cases showed “outflow type”.Conclusion:The efficacy of arterial phase as a distinguishing between pleomorphic adenoma and basal cell adenoma of parotid gland is better than that plain scan and venous phase, and the combination of MSCT dual-phase enhancement features can provide a reliable basis for differential diagnosis of pleomorphic adenoma and basal cell adenoma of parotid gland.