Diagnostic value of high-resolution ultrasonography in parotid space occupying lesions
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摘要: 目的 探讨高频超声在腮腺占位性病变中的诊断价值。方法 回顾性分析102例经手术或穿刺病理证实腮腺占位性病变患者的超声表现及特征, 观察病变的大小、边界、形态、内部回声、无回声区、后方回声、血供情况及部分周围伴随征象。结果 102例腮腺占位性病变患者中, 良性病变组91例, 超声诊断符合率为83.5%;恶性病变组11例, 超声诊断符合率为72.7%。良性与恶性病变在边界、形态、血流检出率上的差异有统计学意义(P < 0.05)。良性病变组中以多形性腺瘤和腺淋巴瘤最多(占70.3%), 二者在形态、内部回声均匀性、有无回声区上的差异有统计学意义(P < 0.05)。85.7%的其他少见腮腺良性肿瘤在术前能够正确诊断为良性, 但难以判断病变病理类型。结论 高频超声检查对腮腺占位性病变的良恶性, 以及良性肿瘤中多形性腺瘤与腺淋巴瘤的鉴别诊断有重要价值, 但对于低度恶性腮腺肿瘤的定性诊断以及少见腮腺占位性病变病理分型的诊断符合率较低, 仍需要进一步穿刺活检或手术切除以明确诊断。Abstract: Objective To evaluate the value of high-resolution ultrasonography in the diagnosis of parotid space occupying lesions.Method Ultrasonographic findings of 102 patients with pathologically proved parotid lesions were retrospectively analyzed. The size, margin, shape, internal echoes distribution, presence of anechoic areas, blood flow signal and accompanying signs of the lesions were observed.Result Of 102 cases, there were 91 benign lesions, the conform rate was 83.5%; there were 11 malignant lesions, the conform rate was 72.7%. Between benign and malignant lesions, the differences of margin, shape and the detection rate of blood flow signal were statistically significant(P < 0.05). Among the benign lesions, pleomorphic adenoma and adenolymphoma were the most common. The shape, internal echoes distribution and presence of anechoic areas were significantly different between these two diseases(P < 0.05). Of other rare benign tumors, 85.7% cases could be correctly diagnosed as benign before surgery, but the correct diagnosis rate for pathological types of lesions was low.Conclusion Parotid lesions with unique ultrasonographic characteristics which are helpful in differentiating the benign neoplasms from the malignant ones, as pleomorphic adenoma from adenolymphoma. However, it is difficult to identify the qualitative diagnosis of low-grade malignant parotid neoplasms and the pathological classification of rare parotid lesions with ultrasonography, and further biopsy or surgical resection is needed to confirm the diagnosis.
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Key words:
- ultrasonography /
- parotid neoplasms /
- diagnosis, differential
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表 1 良性病变组和恶性病变组的超声表现比较
例 组别 例数 边界 形态 内部回声 无回声区 血供情况 清晰 欠/不清晰 规则 欠/不规则 均匀 欠/不均匀 有 无 有 无 良性病变组 91 831) 8 641) 27 32 59 35 56 531) 38 多形性腺瘤 26 24 2 132) 13 12 142) 62) 20 14 12 腺淋巴瘤 38 35 3 30 8 7 31 19 19 29 9 恶性病变组 11 3 8 1 10 3 8 4 7 10 1 与恶性病变组比较，1)P < 0.05；与腺淋巴瘤比较，2)P < 0.05。 
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