Analysis of multimodal ultrasound in differential diagnosis of salivary gland tumors

doi:10.19439/j.sjos.2022.04.009

Abstract

Abstract: PURPOSE: To explore the differential diagnosis of salivary gland tumors by multimodal ultrasound and to establish a preliminary scoring system by assigning meaningful parameters. METHODS: Seventy-seven tumors from 69 patients with salivary gland tumors were examined by two-dimensional gray-scale ultrasound, color Doppler flow imaging (CDFI), superb microvascular imaging(SMI), real time tissue elastography(RTE) and acoustic radiation force impulse (ARFI). Different scoring schemes were obtained for the assignment and combination of meaningful parameters. The ROC curve of each scheme was drawn, and the one with the largest area under the curve was taken as the best scoring scheme. SPSS 25.0 software package was used for statistical analysis of the data. RESULTS: There were significant differences in tumor shape, boundary, posterior echo, blood flow resistance index, RTE grade and ARFI average value between benign and malignant salivary gland tumors(P<0.05). The scoring scheme 7, which was composed of the above 6 parameters, was the best scoring scheme. When each parameter was assigned a score of 1, the total score was 6, and the area under the curve was 0.944. The sensitivity, specificity and accuracy of distinguishing benign and malignant salivary gland tumors with ≥4 points were 80.0%, 98.4% and 94.8%, respectively. CONCLUSIONS: Application of multimodal ultrasound and establishment of a scoring system can effectively improve the ability of ultrasound in the differential diagnosis of benign and malignant salivary gland tumors.

Key words: Salivary gland tumors, Multimodal ultrasound, Scoring system

CLC Number:

R739.8

LYU Huan, XIONG Ping, ZHANG Wei-qian, GONG Xia, LI Jia, DING Ang-ang. Analysis of multimodal ultrasound in differential diagnosis of salivary gland tumors[J]. Shanghai Journal of Stomatology, 2022, 31(4): 384-388.

References

[1] Lombardi D, McGurk M,Vander Poorten V, et al. Surgical treatment of salivary malignant tumors[J]. Oral Oncol, 2017, 65: 102-113.
[2] Mansour N, Bas M, Stock KF, et al.Multimodal ultrasonographic pathway of parotid gland lesions[J].Ultraschall Med, 2017, 38(2): 166-173.
[3] Zhao L, Mu J, Mao Y, et al.The diagnostic value of superb microvascular imaging in identifying benign tumors of parotid gland[J]. BMC Med Imaging, 2020, 20(1): 107-117.
[4] 朱浩, 吴顺营, 赵文晖, 等. 腮腺恶性肿瘤的常规超声和超声造影表现分析[J]. 中国超声医学杂志, 2020, 36(8): 749-752.
[5] Jiang LP.Characteristics of pleomorphic adenomas, adenolymphomas, and malignant tumors of the salivary glands on color doppler ultrasonography and contrast enhanced ultrasonography[J]. Eur Rev Med Pharmacol Sci, 2020, 24(22): 11509-11517.
[6] Zhang YF, Li H, Wang XM, et al.Sonoelastography for differential diagnosis between malignant and benign parotid lesions: a meta-analysis[J]. Eur Radiol, 2019, 29(2): 725-735.
[7] Zengel P, Notter F, Clevert DA.VTIQ and VTQ in combination with B-mode and color Doppler ultrasound improve classification of salivary gland tumors, especially for inexperienced physicians[J]. Clin Hemorheol Microcirc, 2018, 70(4): 457-466.
[8] Matsuda E, Fukuhara T, Donishi R, et al.Clinical utility of qualitative elastography using acoustic radiation force impulse for differentiating benign from malignant salivary gland tumors[J]. Ultrasound Med Biol, 2021, 47(2): 279-287.
[9] Wei X, Li Y, Zhang S, et al.Evaluation of microvascularization in focal salivary gland lesions by contrast-enhanced ultrasonography (CEUS) and Color Doppler sonography[J]. Clin Hemorheol Microcirc, 2013, 54(3): 259-271.
[10] 韩明丽, 王栋华, 史秋生, 等. 基于超声特征的评分法在腮腺Warthin瘤与混合瘤鉴别诊断中的应用研究[J].中国临床医学影像杂志, 2020, 31(6): 385-389.
[11] 孙艺华, 王宏桥, 贾暮云, 等. 涎腺多形性腺瘤和Warthin瘤的多模态超声诊断及Logistic回归分析[J]. 中国超声医学杂志, 2019, 35(8): 673-676.
[12] Kong X, Li H, Han Z.The diagnostic role of ultrasonography, computed tomography, magnetic resonance imaging, positron emission tomography/computed tomography, and real-time elastography in the differentiation of benign and malignant salivary gland tumors: a meta-analysis[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2019, 128(4): 431-443.
[13] Hellquist H, Paiva-Correia A,Vander Poorten V, et al.Analysis of the clinical relevance of histological classification of benign epithelial salivary gland tumours[J]. Adv Ther, 2019, 36(8): 1950-1974.
[14] Li J, Gong X, Xiong P, et al.Ultrasound and computed tomography features of primary acinic cell carcinoma in the parotid gland: a retrospective study[J]. Eur J Radiol, 2014, 83(7): 1152-1156.
[15] 赵志国, 高丹, 王瑾, 等. 896例腮腺肿瘤临床回顾分析[J]. 上海口腔医学, 2017, 26(6): 605-609.
[16] Mansour N, Bobenstetter L, Mansour S, et al.Differentiation of ultrasonographic hypoechoic head and neck lesions[J]. Laryngorhinootologie, 2019, 98(10): 701-707.