摘要
目的临床上,不同性质腮腺肿瘤的治疗方案和远期预后存在着较大的差异性,本研究旨在探讨彩色多普勒超声(color Doppler ultrasound,CDUs)结合磁共振扩散加权成像(diffusion weighted imaging,DWI)对腮腺常见肿瘤的定性诊断价值。方法对江苏省肿瘤医院2013-12-01-2017-12-01收治的55例腮腺肿瘤(22例多形性腺瘤,15例腺淋巴瘤,18例恶性肿瘤)患者的超声及磁共振资料进行回顾性分析,研究CDUs阻力系数(resistance index,RI)与DWI表观扩散系数(apparent diffusion coefficient,ADC)值对不同腮腺肿瘤的定性诊断效能,并与其病理结果进行对照分析。结果Kruskal-Wallis检验不同性质腮腺肿瘤RI值,总体比较差异有统计学意义,H=24.73,P<0.001;组间多重比较显示,腮腺恶性肿瘤RI值与多形性腺瘤、腺淋巴瘤比较均差异有统计学意义,均P<0.001;而多形性腺瘤与腺淋巴瘤RI值差异无统计学意义,P=0.358。取RI值≥0.68诊断腮腺恶性肿瘤时,曲线下面积为0.906,对应的敏感度、特异度分别为83.33%(15/18)、83.78%(31/37)。单因素方差分析不同腮腺肿瘤ADC值,总体比较差异有统计学意义,F=19.290,P<0.001;组间多重比较显示,腮腺多形性腺瘤ADC值与恶性肿瘤、腺淋巴瘤比较差异均有统计学意义,均P<0.001;而恶性肿瘤与腺淋巴瘤ADC值差异无统计学意义,P=0.206。取ADC值≥1.02×10^(-3) mm^2/s诊断多形性腺瘤时,曲线下面积为0.873,对应的敏感度、特异度分别为72.73%(16/22)、90.91%(30/33)。取RI值<0.68且ADC值<1.02×10^(-3) mm^2/s诊断腺淋巴瘤时,曲线下面积为0.812,对应的敏感度、特异度分别为80.00%(12/15)、82.50%(33/40)。结论 CDUs结合MR-DWI对腮腺肿瘤具有较高的定性诊断价值,为临床工作提供了重要的参考依据。
OBJECTIVE Different types of parotid tumors have different treatment regimens and long-term outcomes in clinical practice.This study aims to evaluate the value for diagnosis of common parotid tumors by color Doppler ultrasound（CDUs）combined with diffusion weighted imaging（DWI）.METHODS CDUs and DWI of 55 patients with parotid tumors enrolled in Jiangsu Cancer Hospital from December 2013 to December 2017,including 22 cases of pleomorphic adenoma,15 cases of a adenolymphomas and 18 cases of malignant tumors were analyzed retrospectively.The diagnostic utility of resistance index（RI）and apparent diffusion coefficient（ADC）for different parotid tumors were analyzed and compared with pathological findings.RESULTS Kruskal-Wallis test showed that RI values had significant differences among different types of parotid tumors（H=24.73,P〈0.001）.Multiple comparison between groups showed that RI values of malignant tumors was statistically different from pleomorphic adenoma,adenolymphomas（P〈0.001）,but there was no statistical difference between pleomorphic adenomas and adenolymphomas（P=0.358）.Taking into consideration of RI≥0.68 as the threshold for diagnosis of malignant tumors,the area under the curve was 0.906.The sensitivity and specificity were 83.33%（15/18）and 83.78%（31/37）,respectively.One-way ANOVA showed that ADC values had significant differences among three groups（F=19.290,P〈0.001）.Multiple comparison between groups showed that ADC values of pleomorphic adenoma was statistically different from adenolymphomas and malignant tumor（P〈0.001）,but there was no statistical difference between adenolymphomas and malignant tumor（P=0.206）.Taking ADC≥1.02×10^-3 mm^2/s as the threshold for diagnosis of pleomorphic adenoma,the area under the curve was 0.873.The sensitivity and specificity were 72.73%（16/22）and 90.91%（30/33）,respectively.Taking RI0.68 and ADC1.02×10^-3 mm^2/s as the threshold for diagnosis of adenolymphomas,the area under the curve was 0.812.The se
作者
韦光亮
谭旭艳
WEI Guang-liang;TAN Xu-yan(Department of Ultrasound,Hongze District People＇s Hospital of Huaian,Huaian 223100,P.R.China;Department of Ultrasound,Jiangsu Provincial Tumor Hospital,Nanjing 210009,P.R.China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2018年第13期956-961,共6页
Chinese Journal of Cancer Prevention and Treatment
