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Evaluation of the value of contrast-enhanced ultrasonography in diagnosis of43patients with parotid tumors
CHEN Ze-yuan, LIU Yi-bin, ZAIMIRE Yibulayin, ZHANG Si-min, MAIMAITITUXUN Tuerdi
2022, 20 (2):
177-183.
doi: 10.19438/j.cjoms.2022.02.014
PURPOSE: To evaluate the value of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of parotid tumors. METHODS: This study cohort comprised 43 patients with parotid gland tumors. The pathological classification of tumors included 31 benign tumors and 12 malignant tumors. The characteristics of CEUS images collected during ultrasound examination included wash-in pattern (fast in, slow in or isochronous), wash-out pattern (fast out, slow out and isochronous), enhancement intensity (hight, equal or low), and texture of enhancement (homogeneous and heterogeneous ).The region of interest (ROI) was outlined, the time intensity curve (TIC) was drawn, and the quantitative parameters were obtained through instrumental analysis, including time of arrival (AT), time of peak arrival (TTP), peak intensity (PI), ascending slope(AS), descending time/2 (DT/2), half falling branch slope (DS) and area under the curve(AUC). Then, through the travel value of the parameters between the tumor and surrounding normal tissue, △symbol was added before using the parameters. Based on the analysis of the data, CEUS performance among parotid tumors and difference of quantitative parameters were obtained, and then quantitative parameters were drawn to the working characteristic curve of the subjects to get the best cut-off value, sensitivity and specificity. SPSS 25.0 software package was used for data analysis. RESULTS: There were significant differences between benign parotid tumors and malignant tumors in wash-in pattern, wash-out pattern, enhancement intensity and texture of enhancement(P<0.05).There was significant difference in △AUC between pleomorphic adenomas (PA) and Warthin's tumor (WT) in benign parotid tumors (P<0.05). There were significant differences in DS, AUC, △PI, △AS and △AUC between benign and malignant parotid tumors(P<0.05). Analysis of ROC curve showed that the best cut-off value of △AUC of PA and WT was -103.94, the sensitivity was 100%, and the specificity was 46.20%(ROC-AUC=0.766,P<0.05). In benign and malignant tumors of parotid gland, the best cut-off value of AUC was 1422.165, the sensitivity was 83.30%, the specificity was 60%(ROC-AUC=0.728,P<0.05); the best cut-off value of PI was 0.535, the sensitivity was 83.30%, and the specificity was 60%(ROC-AUC=0.794,P<0.05); the best cut-off value of △AUC was 271.37, the sensitivity was 91.7%, and the specificity was 60% (ROC-AUC=0.797, P<0.05). CONCLUSIONS: CEUS has important value in differential diagnosis of parotid tumors.
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