Early results of real-time qualitative sonoelastography in the evaluation of parotid gland masses: a study with histopathological correlation
Early results of real-time qualitative sonoelastography in the evaluation of parotid gland masses: a study with histopathological correlation
复制标题
DOI：
10.1258/ar.2012.120405
复制
发表时间：
2013-02-01
期刊：
影响因子：
1.3
通讯作者：
Mahmutoglu, Abdullah S.
中科院分区：
文献类型：
--
作者：
Celebi, Irfan;Mahmutoglu, Abdullah S.
背景：超声弹性成像已被用于鉴别乳腺、前列腺、肝脏、血管、甲状腺、肌肉骨骼结构和唾液腺等多种组织的良恶性病变。目的：评价实时定性超声弹性成像在腮腺局灶性病变鉴别诊断中的作用和应用。材料和方法：对75例腮腺局灶性病变患者(男36例，女39例；年龄10~83岁；年龄10~83岁)进行超声弹性成像检查，并由两位专业放射科医师对其进行解释。这些专家根据肿块的相对硬度对病变进行分类和评分，并将结果与组织病理学结果进行比较。1~4分的超声弹性图评分解释如下：1，柔软；2，大部分柔软；3，大部分僵硬；4，僵硬。结果：Kappa统计量为0.508(P<；0.001)显示两位放射科医生之间的一致性较好。超声弹性评分正确诊断49个良性肿瘤中的30个(敏感度为61.2%)和32个恶性肿瘤中的19个(特异度为59.4%)。受试者-操作特征曲线下面积为0.603。超声弹性图对多形性腺瘤、Wartin瘤、腺样囊性癌和高级别肿瘤的诊断价值较低，而对低级别肿瘤如粘液表皮样癌、腺泡细胞癌和基底细胞癌转移的诊断价值较高。结论：虽然超声弹性图在低度恶性肿瘤的鉴别诊断中似乎有希望，但目前放射学的主要作用仅限于确定腮腺肿瘤的位置、大小和形态。
Background: Sonoelastography has been used to differentiate malignant from benign lesions in numerous types of tissues including breast, prostate, liver, blood vessels, thyroid, musculoskeletal structures, and salivary glands.Purpose: To evaluate the efficacy and application of real-time qualitative sonoelastography in the differentiation of benign and malignant focal parotid gland lesions.Material and Methods: A total of 75 patients (36 boys/men, 39 girls/women; age range, 10-83 years) with 81 lesions were evaluated prospectively by sonoelastography performed and interpreted by two expert radiologists. The results of these experts classification and scoring of lesions according to relative stiffness of the mass were compared with each other and with histopathological findings. The interpretation of sonoelastography scores of 1-4 were as follows: 1, soft; 2, mostly soft; 3, mostly stiff; and 4, stiff.Results: The kappa statistic of 0.508 (P < 0.001) indicated moderate agreement between the two radiologists. The sonoelastography scores correctly diagnosed 30 of 49 benign tumors (sensitivity, 61.2%) and 19 of 32 malignant tumors (specificity, 59.4%). The area under the receiver-operating characteristic curve was 0.603. The diagnostic value of sonoelastography for evaluating pleomorphic adenomas, Warthin tumors, adenoid cystic carcinoma, and high-grade tumors was low, whereas the diagnostic rates for low-grade tumors such as mucoepidermoid carcinoma, acinic cell carcinoma, and metastases of basal cell carcinoma were better with sonoelastography.Conclusion: Although sonoelastography seems to be promising in the differentiating of low-grade malignancies, the primary role of radiology is currently limited to determination of localization, size, and morphology of parotid tumors.