| Objective: To investigate the diagnostic value of CEUS parameters and DVPC in the histopathological classification of PA of parotid gland.Method: We retrospectively included parotid gland tumors cases in the Department of Oral and Maxillofacial Surgery,Qingdao University Affiliated Hospital from August 2015 to May 2019,and finally selected 60 cases of parotid pleomorphic adenoma.According to the ratio of stroma and epithelium in pleomorphic adenoma,if the tumor stromal content is less than 40%,it is defined as stroma-poor type;40% ～ 60%,intermediate-stroma type;over60%,stroma-rich type.We use Sono Liver software to analyze the contrast-enhanced ultrasound dynamic image,and draw 3 regions of interest(ROI)on the contrast-enhanced ultrasound image,which are boundary ROI,lesion ROI,and reference ROI,and through the software to obtain the time-intensity curve(TIC)parameters,including: maximum intensity(IMAX),rising time(RT),time to peak(TTP),mean transit time(m TT),Quality of Fit(QOF),and calculate the ascending slope(AS)and descending slope(DS);and the Sono Liver analysis software obtain automatically dynamic vascular pattern curve(DVPC).Then observe the correlation between the stromal content of pleomorphic adenomas and TIC of CEUS,then compare and analyze the differences of TIC and DVPC of the three types of pleomorphic adenomas.Results: Among 60 cases of pleomorphic adenoma of parotid gland,there were 19 cases of stroma-poor PA,12 cases of intermediate-stroma PA and 29 cases of stroma-rich PA.There is significant correlation between the tumor stromal content and IMAX,AS,DS in TIC(r=-0.792,-0.803,-0.755 respectively,P< 0.05),where as RT,TTP,m TT have no significant correlation(r=-0.010,-0.080,-0.079 respectively,P>0.05).The IMAX of stroma-poor PA,intermediate-stroma PA,and stroma-rich PA were(261.8±137.2)%,(114.4±27.1)%,and(50.9±31.3)%,there was statistically significant difference in IMAX between any two of the three groups respectively(P<0.05);The AS of stroma-poor PA,intermediate-stroma PA,and stroma-rich PA were(28.9±10.0)%/s,(15.5±5.3)%/s,and(6.9±3.8)%/s,and there was statistically significant difference in AS between any two of the three groups respectively(P<0.05);The DS of stroma-poor PA,intermediate-stroma PA,and stroma-rich PA were(17.6±11.5)%/s,(10.8±5.3)%/s,(3.9±2.5)%/s,there was statistically significant difference in DS between any two of the three groups respectively(P<0.05);The RT of stroma-poor PA,intermediate-stroma PA,and stroma-rich PA were(9.4±2.8)s,(8.2±2.6)s,and(7.9±3.2)s,there was no statistically significant difference in RT between any two of the three groups respectively(P>0.05);The TTP of stroma-poor PA,intermediate-stroma PA,and stroma-rich PA were(19.7±6.2)s,(16.6±1.9)s,and(18.1±4.2)s,there was no statistically significant difference in TTP between any two of the three groups respectively(P>0.05);The m TT of stroma-poor PA,intermediate-stroma PA,and stroma-rich PA were(24.1±8.1)s,(19.9±3.8)s,and(20.8±4.8)s,there was no statistically significant difference in m TT between any two of the three groups respectively(P>0.05);In the dynamic vascular pattern curve analysis of pleomorphic adenomas,84.2% of stroma-poor PA have positive waves,41.7% of intermediate-stroma PA have positive and negative two-way waves,and 82.8% of stromarich PA have negative waves.The dynamic mode curve differences among various types of PA are statistically significant(P<0.05).Conclusion: By using CEUS,the TIC and its DVPC can be regarded as an independent and quantitative method for evaluating parotid PA,which is relatively reliable.The use of CEUS to determine the preoperative pathological properties and classification of parotid gland PA before operation has great guiding significance for the surgical plan of PA. |
PDF Full Text Request