腮腺多形性腺瘤和腺淋巴瘤的MSCT征象鉴别诊断价值

Diagnostic value of MSCT signs in differentiating parotid pleomorphic adenoma and adenolymphoma

目的:探讨MSCT征象对术前鉴别诊断腮腺多形性腺(PA)和腺淋巴瘤(AL)的临床价值。方法:回顾性收集经术后病理确诊的122例腮腺肿瘤患者的临床和影像资料,包括PA和AL各61例。统计分析临床资料、MSCT征象在两组肿瘤间的差异,并采用受试者操作特性曲线(ROC)评价单参数及多参数联合鉴别PA和AL的诊断效能。结果:年龄、性别、吸烟率、多发性、浅后下极、血管贴边征、平扫CT值、动脉期(AP)净强化值、强化方式在两组间差异具有统计学意义(P<0.05),两组间病变长径、形态、浅深叶、上下极、边缘、囊变差异无统计学意义(P>0.05)。ROC分析各特征鉴别诊断AUC范围为0.596~0.889,其中AP净强化值AUC最高,灵敏度、特异度分别为93.75%、72.13%。AP净强化值和强化方式联合诊断AUC为0.921,灵敏度、特异度分别为88.39%、86.89%。结论:MSCT征象对腮腺PA和AL的诊断及鉴别诊断有重要价值。

Objective:To investigate the clinical value of MSCT signs for preoperative differential diagnosis between parotid pleomorphic adenoma(PA)and adenolymphoma(AL).Methods:The clinical and imaging data of 122 patients with parotid gland tumors confirmed by postoperative pathology were collected retrospectively,including 61 cases of PA and 61cases of AL.The differences of clinical data and MSCT signs were statistically analyzed between the two groups,and receiver operating characteristic curve(ROC)was used to evaluate the discrimination efficacy.Results:Age,gender,smoking rate,multiplicity,superficial posteroinferior pole,marginal vascular sign,plain CT value,pure enhanced value in arterial phase(AP),and enhanced pattern showed statistically significant differences between the two groups(P<0.05),while there was no significant difference in lesion length,morphology,superficial or deep lobe,superior or inferior pole,rim,and cystic between the two groups(P>0.05).The AUC of ROC analysis for the differential diagnosis of each feature ranged from 0.596 to 0.889,AP pure enhanced value had the highest AUC,with a sensitivity and specificity of 93.75%and 72.13%.The combined diagnostic AUC of AP pure enhanced value and enhancement pattern was 0.921,with a sensitivity and specificity of 88.39%and 86.89%,respectively.Conclusion:MSCT signs are valuable for the diagnosis and differential diagnosis of parotid PA and AL.