Shear wave elastography of focal salivary gland lesions: preliminary experience in a routine head and neck US clinic
Shear wave elastography of focal salivary gland lesions: preliminary experience in a routine head and neck US clinic
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DOI：
10.1007/s00330-011-2364-3
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发表时间：
2012-05-01
影响因子：
5.9
通讯作者：
Ahuja, Anil T.
中科院分区：
文献类型：
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作者：
Bhatia, Kunwar S. S.;Cho, Carmen C. M.;Ahuja, Anil T.
目的探讨剪切波弹性成像（SWE）对腮腺局灶性病变的诊断价值。方法60个病灶（腮腺49个，颌下11个）在常规超声（灰阶和多普勒）检查后，在超声引导下穿刺细胞学检查前进行SWE检查。结果良性病变55例（多形性腺瘤21例，Warthin瘤18例，其他16例），恶性病变5例（粘液表皮样癌2例，肌上皮癌1例，B细胞淋巴瘤1例，淋巴结转移1例）。良性病变的剪切模量中位数为18.3 kPa，与恶性病变的剪切模量中位数为13.5 kPa明显重叠。2例粘液表皮样癌硬度值最高（81.9kPa、132.0kPa）。多形性腺瘤的硬度（中位数22.5 kPa）高于Warthin肿瘤（16.9 kPa）（P = 0.05 Mann-Whitney U检验）。病变内硬度值的标准差，作为空间异质性的指标，在粘液表皮样癌中最高（中位数44.2千帕），其次是多形性腺瘤（中位数12.4 kPa）和剩余病变（中位数1.4-10.3千帕）结论尽管SWE在判断乳腺癌的病理类型方面表现出次优的表现，但本研究显示了SWE指标在一定程度上的聚集性。剪切波弹性成像是一种用于局部涎腺病变的可行技术。局部解剖结构加重的弹性成像伪影可能会阻碍这项技术。弹性成像指数根据病理学而变化，但存在明显的重叠。恶性和良性病变的重叠指数限制了其实用性。多形性腺瘤具有较高的弹性指数，即较硬，比沃辛的肿瘤更严重
Objectives To evaluate shear wave elastography (SWE) for focal lesions in major salivary glands.Methods Sixty lesions (49 parotid, 11 submandibular) undergoing routine ultrasound (grey scale and Doppler) also underwent SWE before US-guided needle aspiration for cytology. Quantitative indices of the shear elastic modulus (stiffness) were compared with cytological results.Results Fifty-five lesions were benign (21 pleomorphic adenomas, 18 Warthin's tumours; 16 others) and 5 malignant (2 mucoepidermoid carcinomas, 1 myoepithelial carcinoma, 1 B-cell lymphoma, 1 nodal metastasis). Shear modulus of benign lesions, median 18.3 kPa, overlapped appreciably with malignant lesions, median 13.5 kPa. However, 2 mucoepidermoid carcinomas had the highest stiffness values (81.9 kPa, 132.0 kPa). Stiffness of pleomorphic adenomas (median 22.5 kPa) was higher than Warthin's tumours (16.9 kPa) (P = 0.05 Mann-Whitney U-test). The standard deviation of stiffness values within a lesion, used as an indicator of spatial heterogeneity, was highest in mucoepidermoid cancers (median 44.2 kPa), followed by pleomorphic adenomas (median 12.4 kPa) and remaining lesions (medians 1.4-10.3 kPa).Conclusion This study shows a degree of clustering of SWE indices according to pathology although it appears that SWE has suboptimal performance for ruling out malignancy, thus limiting its use in routine practice.Key PointsShear wave elastography is a feasible technique for focal salivary gland lesions.Elastographic artefacts aggravated by the regional anatomy may hinder this technique.Elastographic indices vary according to pathology but there is appreciable overlap.Overlapping indices for malignant and benign lesions limit its utility.Pleomorphic adenomas have higher elasticity indices, i.e. are stiffer, than Warthin's tumours.