The Value Of Contrast-enhanced Ultrasound And Shear Wave Elastography In Differentiating Oral Tumors

Part ? Application of intraoral ultrasound in the diagnosis of oral tumorsObjective:To explore the diagnostic value of intraoral ultrasound in differentiating benign from malignant oral tumors.Method:From November 2017 to January 2020,a total of 481 patients confirmed with histopathologic examination received intraoral ultrasound examination before surgery.The surgical pathological diagnosis was used as the gold standard.The diagnostic performance of intraoral ultrasound was analyzed.Results:Of the 481 oral lesions,the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and accuracy of the intraoral ultrasound in the prediction of oral lesions were 87.1%?81.7%?94.2%?65.0%?85.9%?Conclusion:Intraoral ultrasound is a promising tool that can clearly identify the growth-occult,deep seated oral lesions and differentiate between benign and malignant oral tumors.However,there are overlapping sonograms among different pathological types of oral tumors.Part ? Application of contrast enhanced ultrasound in the diagnosis of oral tumorsObjective:To explore the diagnostic value of contrast enhanced ultrasound(CEUS)in differentiating benign from malignant oral tumors.Method:From November 2017 to January 2020,a total of 138 patients confirmed with histopathologic examination received CEUS intravenously before surgery.The surgical pathological diagnosis was used as the gold standard.The diagnostic performance of CEUS was analyzed.Results:Of the 138 oral lesions,103 lesions were malignant and 35 lesions were benign.The sensitivity and specificity,PPV,NPV and accuracy of the CEUS in the prediction of oral lesions were 93.2%?82.9%?94.1%?80.6%?90.6%?The area under the curve(AUC)was 0.88.Conclusion:CEUS provides a noninvasive,simple and accurate method for qualitative diagnosis and follow-up observation in patients with oral tumors.Part ? Application of shear wave elastography in the diagnosis of oral tumorsObjective:To explore the diagnostic value of shear wave elastography(SWE)in differentiating benign from malignant oral tumors.Method:From November 2017 to January 2020,a total of 416 patients confirmed with histopathologic examination were reviewed in this study,intraoral ultrasonography(US)and SWE examination were performed before surgery.Observers who were blinded to radiologic and pathologic findings analyzed the elasticity parameters.Receiver operating characteristic(ROC)analysis was used to identify the optimal diagnostic and staging feature.The diagnostic concordance rate between elastographic parameters and histopathology were analyzed.Results:Of the 416 oral lesions,the Young modulus of malignant lesion was considerably higher than benign tumor.In ROC curve analysis,the optimal cut-off was 41.0kpa for tongue,24.2kpa for floor of mouth,53.9kpa for hard palate and 39.2kpa for gingiva tumors,Emax achieved larger the area under the curve(AUC)with the sensitivity was 89.7%,100%,100%and 100%,and the specificity was 96.3%,100%,100%and 100%,respectively.The optimal cut-off was36.6 kPa for soft palate and 20.2 kPa for tonsil tumors,Emin achieved larger the area under the curve(AUC)with the sensitivity was was 96.8%and 100%,and the specificity was 100%and 87.5%.Conclusion:SWE is a promising method that yields valuable quantitative data to transoral ultrasound in oral lesions.