剪切波弹性成像技术在腮腺肿瘤诊断中的应用价值研究

Study on the application value of shear wave elastography technology in the diagnosis of parotid gland tumors

目的探讨常规超声联合剪切波弹性成像技术(shear wave elastrography,SWE)在腮腺多形性腺瘤及单形性腺瘤鉴别诊断中的应用价值。方法选取2020年9月至2021年11月我院口腔颌面外科进行腮腺肿瘤手术切除或病理穿刺活检获得病理结果的77例患者(83个腮腺肿瘤),其中多形性腺瘤43例(51.80%),单形性腺瘤40例(48.20%)。所有腮腺肿瘤患者术前或穿刺活检之前均行常规超声及SWE技术检查,评估其超声特征及弹性情况,绘制ROC曲线并计算常规超声及SWE诊断腮腺肿瘤的敏感性及特异性,分析其诊断价值。结果多形性腺瘤血流信号分级低于单形性腺瘤,单形性腺瘤中更容易发现囊性区域,二者血流信号分级及囊性区域比较差异有统计学意义(P<0.05);多形性腺瘤较单形性腺瘤弹性硬度值更高,比较SWE杨氏模量最大值及平均值差异有统计学意义(P<0.05),但杨氏模量最小值比较,差异无统计学意义(P>0.05);常规超声及SWE技术联合诊断腮腺多形性腺瘤的敏感度为88.4%、特异度为77.5%,高于二者单独诊断。结论常规超声联合SWE技术在腮腺多形性腺瘤与单形性腺瘤的鉴别诊断中具有较高的应用价值。

Objective To explore the application value of shear wave elastrography(SWE)in the differential diagnosis of parotid gland pleomorphic adenoma and monomorphic adenoma.Methods From September 2020 to November 2021,77 patients(83 parotid tumors)with pathological results obtained from surgical resection or pathological biopsy of parotid tumors in oral and maxillofacial surgery in our hospital were selected.Of these patients,43(51.80%)were pleomorphic adenoma(PA)and 40(48.20%)were monomorphic adenoma(MA).All patients with parotid gland tumors were examined by conventional ultrasound and SWE before surgery or puncture biopsy.The corresponding ultrasound characteristics and Young's modulus were evaluated.ROC curves were drawn.The sensitivity and specificity of conventional ultrasound and SWE in diagnosing parotid gland tumors were calculated.Their diagnostic value was analyzed.Results The blood flow signal grade of PA was lower than that of MA,and cystic areas were more likely to be found in MA.There is a statistically significant difference in the blood flow signal grade and cystic area between the two types of tumor(P<0.05).PA had higher elastic hardness values han MA,and the difference between the maximum and average values of SWE Young's modulus was statistically significant(P<0.05).However,the minimum value of Young's modulus between PA and MA was not statistically significant(P>0.05).The combined diagnosis of parotid gland PA by conventional ultrasound and SWE technology had a sensitivity of 88.4%and a specificity of 77.5%,which is higher than the two alone.Conclusions The conventional ultrasound combined with SWE technique has higher application value in the differential diagnosis of PA and MA in parotid gland.