Bradley M J, Durham L H, Lancer J M
Department of Clinical Radiology, Rotherham General Hospitals NHS Trust, South Yorkshire, UK.
Clin Radiol. 2000 Oct;55(10):759-62. doi: 10.1053/crad.2000.0541.
Ultrasound is a highly effective imaging technique to determine salivary gland tumours and may help to identify many benign lesions. The aim of this study is to evaluate whether colour Doppler is able to further differentiate the malignant tumour.
Fifty-six patients with salivary gland lesions were prospectively assessed using ultrasound imaging with colour flow and power Doppler. The peak systolic velocity (PSV) was measured and the pulsatility index (PI) and resistive index (RI) calculations were performed on the pulsed wave traces. The real time ultrasound morphology and the Doppler information were correlated with the histology.
In 18 of the 56 patients, no internal colour flow or power Doppler changes could be detected. The real time ultrasound morphology diagnosed benign disease with sensitivity of 89.7% with specificity of 57.1%. The positive predictive value was 93.6%. There were no significant differences in the colour Doppler appearances in terms of vessel type or intratumour distribution which could separate benign from malignant conditions. However, there was statistical discrimination for PI and RI values (P = 0.0006, P = 0.0002, respectively). No malignant lesions were seen when the PI was less than 1.8 and RI was less than 0.8. The PSV was elevated in several cases (> 50 cm per s) but there was no statistical correlation with malignancy.
The risk of malignancy increases by a third when the colour Doppler demonstrates increased intratumour vascular resistance (RI > 0.8 and PI > 1.8), with positive predictive value of 97.3% (sensitivity 75.5%, specificity 85.7%).Bradley, M. J. (2000). Clinical Radiology55, 759-762.
超声是一种用于确定唾液腺肿瘤的高效成像技术，可能有助于识别许多良性病变。本研究的目的是评估彩色多普勒是否能够进一步区分恶性肿瘤。
对56例唾液腺病变患者进行前瞻性评估，采用彩色血流和能量多普勒超声成像。测量收缩期峰值流速（PSV），并在脉冲波迹线上进行搏动指数（PI）和阻力指数（RI）计算。实时超声形态和多普勒信息与组织学结果相关。
56例患者中有18例未检测到内部彩色血流或能量多普勒变化。实时超声形态诊断良性疾病的敏感性为89.7%，特异性为57.1%。阳性预测值为93.6%。在血管类型或肿瘤内分布方面，彩色多普勒表现无显著差异，无法区分良性和恶性病变。然而，PI和RI值存在统计学差异（分别为P = 0.0006，P = 0.0002）。当PI小于1.8且RI小于0.8时，未见恶性病变。有几例患者的PSV升高（>50 cm/s），但与恶性肿瘤无统计学相关性。
当彩色多普勒显示肿瘤内血管阻力增加（RI>0.8且PI>1.8）时，恶性风险增加三分之一，阳性预测值为97.3%（敏感性75.5%，特异性85.7%）。布拉德利，M. J.（2000年）。《临床放射学》55，759 - 762。
