基于超声特征的评分法在腮腺Warthin瘤与混合瘤鉴别诊断中的应用研究

doi:10.12117/jccmi.2020.06.002

摘要
图/表
参考文献(22)
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：探讨基于超声特征的评分法在腮腺Warthin瘤与混合瘤鉴别诊断中的价值。方法：回顾性分析经超声检查并手术病理证实的40个腮腺Warthin瘤和41个腮腺混合瘤病灶病例资料，选择两组患者性别、年龄、最大径、纵横比、病灶数、回声均匀性、网状条索、形态、边界、后方回声、囊性变、钙化灶和血流分级等指标，通过多元逐步Logistic回归分析筛选独立危险因素建立评分系统，绘制受试者工作特征（ROC）曲线计算评分系统的诊断效能。结果：两组患者在性别、年龄、最大径、纵横比、病灶数、回声均匀性、网状条索、血流分级指标上差异有统计学意义（P＜0.05），其中性别、年龄、纵横比、回声均匀性、血流分级5个指标为Warthin瘤的独立危险因素，对每个指标赋予0分或1分建立评分系统，总分0～5分，以≥3分为参数诊断Warthin瘤效能最高，敏感度97.5%，特异度85.36%，准确率91.35%。结论：基于超声特征的评分法评分≥3时，对鉴别腮腺Warthin瘤与混合瘤具有很好的诊断效能。该方法简单实用，适宜推广应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	韩明丽1
	王栋华2
	史秋生1
	陈红燕2
	朱慧2
	杜联芳1

关键词 ：腮腺肿瘤, 腺淋巴瘤, 超声检查, 多普勒, 彩色

Abstract：Objective: To evaluate the value of ultrasound-based scoring system in differential diagnosis of Warthin tumors and pleomorphic adenomas in parotid gland. Methods: Forty Warthin tumors and 41 pleomorphic adenomas were proved by surgical histopathology after the ultrasonography process. And the parameters including gender, age, maximum diameter, height/width ratio, number of lesions, echogenicity, reticular cord, shape, margin, posterior echogenicity, cystic degeneration, calcification and blood flow were retrospectively compared between the groups mentioned above. After that, the independent risk factors were screened by multivariate stepwise Logistic regression analysis. Then, a scoring system was established. The receiver operating characteristic(ROC) curve was also plotted to calculate the diagnostic efficacy of the scoring system. Results: There were statistically significant differences between the two groups in the next eight parameters including gender, age, maximum diameter, height/width ratio, number of lesions, echogenicity, reticular cord, and blood flow(P＜0.05). Furthermore, among of which, the gender, age, height/width ratio, echogenicity, or blood flow was individually independent risk factors to Warthin tumors. The scoring system was established with 0 or 1 point for each risk factor, and the total scores summed up to 0～5 points. The highest efficiency, the sensitivity, specificity and accuracy of the diagnosis of Warthin tumors were 97.5%, 85.36% and 91.35% while the cut-off value of ≥3 was set, respectively. Conclusion: The ultrasound-based scoring system has highly diagnostic efficiency in differentiating Warthin tumors from pleomorphic adenomas in parotid gland. Though simple, but it is an easy way to perform in clinical practice.

Key words： Parotid neoplasms Adenolymphoma Ultrasonography, Doppler, color

收稿日期: 2019-10-11

PACS:	Ｒ739.8
	Ｒ445.1

基金资助:国家自然科学基金资助项目（编号81571677）；上海市松江区科技攻关项目（编号18sjkjgg42）；上海市闵行区自然科学研究课题（编号2019MHZ085）；上海市闵行区中心医院院级课题（编号2018MHLC07）。

通讯作者: 史秋生，上海交通大学附属第一人民医院超声医学科，200080。E-mail：sqs19631989@163.com

作者简介: 韩明丽（1985-），女，江西九江人，主治医师。E-mail：mingli13@163.com

引用本文:

韩明丽1，王栋华2，史秋生1，陈红燕2，朱慧2，杜联芳1. 基于超声特征的评分法在腮腺Warthin瘤与混合瘤鉴别诊断中的应用研究[J]. 中国临床医学影像杂志, 2020, 31(6): 385-389.
HAN Ming-li1, WANG Dong-hua2, SHI Qiu-sheng1, CHEN Hong-yan2, ZHU Hui2, DU Lian-fang1. Ultrasound-based scoring system for differential diagnosis of Warthin tumors and pleomorphic adenomas in parotid gland. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(6): 385-389.

链接本文:

http://www.jccmi.com.cn/CN/10.12117/jccmi.2020.06.002 或 http://www.jccmi.com.cn/CN/Y2020/V31/I6/385

[1]Bradley PJ, McGurk M. Incidence of salivary gland neoplasms in a defined UK population[J]. Br J Oral Maxillofac Surg, 2013, 51(5): 399-403.
[2]Reddy VM, Thangarajah T, Castellanos-Arango F, et al. Conservative management of Warthin tumour[J]. J Otolaryngol Head Neck Surg, 2008, 37(5): 744-749.
[3]Motoori K, Yamamoto S, Ueda T, et al. Inter- and intratumoral variability in magnetic resonance imaging of pleomorphic adenoma: an attempt to interpret the variable magnetic resonance findings[J]. J Comput Assist Tomogr, 2004, 28(2): 233-246.
[4]Yuan WH, Hsu HC, Chou YH, et al. Gray-scale and color Doppler ultrasonographic features of pleomorphic adenoma and Warthin’s tumor in major salivary glands[J]. Clin Imaging, 2009, 33(5): 348-353.
[5]Rong X, Zhu Q, Ji H, et al. Differentiation of pleomorphic adenoma and Warthin’s tumor of the parotid gland: ultrasonographic features[J]. Acta Radiol, 2014, 55(10): 1203-1209.
[6]游珊珊，张波，戴晴，等. 腮腺Wathin’s瘤与多形性腺瘤的超声和临床特征[J]. 中国医学影像技术，2014，30（9）：1296-1299.
[7]Ryoo I, Suh S, Lee YH, et al. Vascular Pattern Analysis on Microvascular Sonography for Differentiation of Pleomorphic Adenomas and Warthin Tumors of Salivary Glands[J]. J Ultrasound Med, 2018, 37(3): 613-620.
[8]朱少明，陈剑，赵齐羽，等. 腮腺多形性腺瘤与Warthin氏瘤的超声图像对比分析[J]. 中国超声医学杂志，2013，29（9）：848-850.
[9]黄冠兰，徐秋华，燕山. 腮腺多形性腺瘤与腺淋巴瘤的超声鉴别研究[J]. 中华超声影像学杂志，2013，22（4）：366-367.
[10]李亚洲，孟凡荣，向维，等. 涎腺多形性腺瘤与Warthin瘤的流行病学资料及彩色多普勒超声声像图对比分析[J]. 南京医科大学学报：自然科学版，2017，37（12）：1657-1659.
[11]Martinoli C, Derchi LE, Solbiati L, et al. Color Doppler sonography of salivary glands[J]. Am J Roentgenol, 1994, 163(4): 933-941.
[12]Ansari MH. Salivary gland tumors in an Iranian population: a retrospective study of 130 cases[J]. J Oral Maxillofac Surg, 2007, 65(11): 2187-2194.
[13]Zajkowski P, Jakubowski W, Bialek EJ, et al. Pleomorphic adenoma and adenolymphoma in ultrasonography[J]. Eur J Ultrasound, 2000, 12(1): 23-29.
[14]Bradley MJ, Durham LH, Lancer JM. The role of colour flow Doppler in the investigation of the salivary gland tumour[J]. Clin Radiol, 2000, 55(10): 759-762.
[15]Luers JC, Guntinas-Lichius O, Klussmann JP, et al. The incidence of Warthin tumours and pleomorphic adenomas in the parotid gland over a 25-year period[J]. Clin Otolaryngol, 2016, 41(6): 793-797.
[16]Miao LY, Xue H, Ge HY, et al. Differentiation of pleomorphic adenoma and Warthin’s tumour of the salivary gland: is long-to-short diameter ratio a useful parameter?[J]. Clin Radiol, 2015, 70(11): 1212-1219.
[17]Yu GY, Ma DQ, Zhang Y, et al. Multiple primary tumours of the parotid gland[J]. Int J Oral Maxillofac Surg, 2004, 33(6): 531-534.
[18]郑玮，郭辉，李安华，等. 腮腺腺淋巴瘤的超声影像诊断——附54例分析[J]. 中国超声医学杂志，2011，27（9）：783-785.
[19]轩维锋. 超声在诊断腮腺Warthin’s瘤中的应用价值[J]. 临床超声医学杂志，2012，14（4）：272-274.
[20]胡冬梅，何雨，郑娟娟，等. 腮腺腺淋巴瘤的超声表现分析[J]. 临床超声医学杂志，2016，8（11）：787-788.
[21]Knopf A, Mansour N, Chaker A, et al. Multimodal ultrasonographic characterisation of parotid gland lesions—a pilot study[J]. Eur J Radiol, 2012, 81(11): 3300-3305.
[22]Bialek EJ, Jakubowski W, Karpinska G. Role of ultrasonography in diagnosis and differentiation of pleomorphic adenomas: work in progress[J]. Arch Otolaryngol Head Neck Surg, 2003, 129(9): 929-933.