The Value Of High Frequency Ultrasonography In The Diagnosis Of Three Types Of Parotid Benign Tumors

Objective:To evaluate the value of high frequency ultrasonography in the diagnosis and antidiastole of parotid pleomorphic adenoma,Warthin’s tumor and basal cell adenoma.In order to improve the diagnostic coincidence rate and reduce the misdiagnosis rate.Materials and methods:In this study,50 patients with benign tumors in parotid gland were collected,including a total of 65 cases(21 cases of pleomorphic adenoma,32 cases of Warthin’s tumor and 12 cases of basal cell adenoma).All patients were examined by ultrasonography before operation in our hospital.According to the pathological results,the patients were divided into 3 groups(A group: pleomorphic adenoma,B group: Warthin’s tumor,C group: basal cell adenoma).To compare the sensitivity,specificity and coincidence rate of sonographic features(shape of tumor,internal echo,posterior echo,blood flow signal intensity,etc.)of three types of parotid gland benign tumors.Established receiver operating characteristic curve,to explore the diagnostic and antidiastole value of these three kinds of parotid benign tumors.Results:1.Pleomorphic adenoma,Warthin’s tumor,basal cell adenoma can be solitary or multiple.2.There were significant differences in age and gender among the three groups(P<0.05),Which was contribute to diagnosis.3.There were significant differences in the shape of the parotid benign tumors,the uniformity of the internal echo and the enhancement of the echo in the univariate analysis(P value was 0.001,0.036 and 0.010,respectively)."Lobulated" was most common seen in pleomorphic adenoma(14/21).The internal echo of the Warthin’s tumor is heterogeneous(24/32),and the posterior echo is enhanced(23/32).4.The blood flow signal intensity was statistically significant in univariate analysis(P<0.05).The 0 and I degrees of blood flow signals were confirmed in the pleomorphic adenoma(17/21);the II and III degrees were identified in Warthin’s tumor and basal cell adenoma(25/32 and 9/12,respectively).5.There was no significant difference among the three tumors in boundary,internal echo and mean maximum diameter(P values were0.489,0.565,0.358,respectively).6.The highest coincidence rate of the four ultrasonic features in the diagnosis of pleomorphic adenoma was lack of blood supply(about78.46%).The highest coincidence rate in the diagnosis of Warthin’s tumorwas sufficient blood(69.23%).The highest coincidence rate in the diagnosis of basal cell adenoma was the uniformity of internal echo(67.69%).7.ROC and multivariate observation of ROC shows the irregular shape,no enhancement of the posterior echo,less blood supply can increase the diagnostic accuracy of pleomorphic adenoma.And the combination of the three ultrasonic features can improve the diagnostic accuracy.Morphological regularity and more blood supply has a high value in diagnosis of Warthin’s tumor,the combination of these features can improve the diagnostic accuracy.There was no statistical significance by evaluating the singled performance of the morphological regularity,internal echo uniform,posterior echo enhancement and blood flow signal in basal cell adenoma diagnosis.Correspondingly,the diagnostic accuracy of basal cell adenoma can be improved when we combine the four ultrasonic features.Conclusion:1.Age and sex can be used as the reference standard for the identification of these three types of parotid benign tumors.2.Irregular shape(lobulated)was most common seen in pleomorphic adenoma.Both pleomorphic adenoma and Warthin’s tumor have uneven internal echo.Compare with the pleomorphic adenoma,the Warthin’s tumor and basal cell adenoma have an enhanced posterior echo.3.Among these benign tumors,the blood flow signal of Warthin’s tumor and basal cell adenoma were rich,but pleomorphic adenoma was poor.4.Each sonographic feature is valuable in the diagnosis of parotid benign tumors,but it is of limited significance for the differential diagnosis of these three types of parotid benign tumors.It is necessary to fully understand the ultrasonographic characteristics of these tumors,and the improvement of diagnostic accuracy can be expected by combining observation of multiple ultrasonic features.