Use-of cross-sectional imaging in predicting surgical location of parotid neoplasms
Use-of cross-sectional imaging in predicting surgical location of parotid neoplasms
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DOI：
10.1097/01.rct.0000161758.25130.34
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发表时间：
2005-05-01
影响因子：
1.3
通讯作者：
Mukherji, SK
中科院分区：
文献类型：
--
作者：
Divi, V;Fatt, MA;Mukherji, SK
目的：本研究的目的是确定使用下颌后静脉横截面成像，以帮助区分浅叶从深叶tumors.Methods的诊断准确性：1997年1月至2002年7月之间的腮腺肿瘤的患者，我们能够确定44例术前影像学研究，可用于评估。由一名头颈部放射科医生审查这些影像，以确定肿瘤是否累及腮腺的浅叶、深叶或两叶（全部）。下颌后静脉的外侧缘被用作面神经的标记，因为神经在CT和MRI扫描中并不总是可见的。然后将放射科医生的发现与手术期间的发现进行比较。然后计算预测肿瘤位置的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。对于浅叶病变，横断面成像能够预测肿瘤的位置，灵敏度为0.91（95% CI，0.70-0.98），特异性0.86（95% CI，0.63-0.96），PPV 0.88（95% CI，0.67-0.97），NPV 0.90（95% CI，0.67 - 0.98）。对于两个肺叶的病变（全部），横断面成像能够预测肿瘤的位置，灵敏度为0.94（95% CI，0.68-0.99），特异性为0.89（95% CI，0.71-0.97），PPV为0.83（95% CI，0.58-0.96），NPV为0.96（95% CI，0.78-0.99）。使用下颌后静脉作为面神经的标记是在横断面影像上识别腮腺肿瘤位置的敏感方法。这支持了使用术前成像检测腮腺肿瘤相对于面神经的位置的准确性。
Objective: The purpose of this study was to determine the diagnostic accuracy of using the retromandibular vein as seen on cross-sectional imaging to help differentiate superficial lobe from deep lobe tumors.Methods: Of the patients who bad Parotid neoplasms between January 1997 and July 2002, we were able to identify 44 patients with preoperative imaging studies that were available for evaluation. The films were reviewed by a single head and neck radiologist to determine whether the neoplasms involved the superficial, deep, or both lobes of the parotid gland (total). The lateral margin of the retromandibular vein was used as a marker for the facial nerve, since the nerve is not always visible on CT and MRI scans. The radiologist's findings were then compared with the findings during surgery. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of predicting the location of neoplasms were then calculated.Results: For lesions in the superficial lobe, cross-sectional imaging was able to predict the location of the neoplasm with a sensitivity of 0.91 (95% CI, 0.70-0.98), specificity of 0.86 (95% CI, 0.63-0.96), PPV of 0.88 (95% Cl, 0.67-0.97), and NPV of 0.90 (95% CI, 0.670.98). For lesions in both lobes (total), cross-sectional imaging was able to predict the location of the neoplasm with a sensitivity of 0.94 (95% CI, 0.68-0.99), specificity of 0.89 (95% CI, 0.71-0.97), PPV of 0.83 (95% CI, 0.58-0.96), and NPV of 0.96 (95% CI, 0.78-0.99).Conclusion: Use of the retromandibular vein as a marker for the facial nerve is a sensitive method for identifying the location of parotid gland neoplasms on cross-sectional imaging. This supports the accuracy of using preoperative imaging to detect the position of parotid neoplasms with respect to the facial nerve.