Knopf Andreas, Cortolezis Nikolaus, Bas Murat, Mansour Naglaa, Hofauer Benedikt
a Department of Otorhinolaryngology/Head and Neck Surgery , Technische Universität München , München , Germany.
Acta Otolaryngol. 2017 Jun;137(6):640-645. doi: 10.1080/00016489.2016.1269363. Epub 2017 Jan 13.
The multimodal diagnostic algorithm is a simple diagnostic tool in the pre-operative assessment of submandibular masses that enables one-stage surgical concepts.
The pre-operative assessment of submandibular masses is of major clinical impact. This study assesses the diagnostic utility of a newly introduced diagnostic algorithm in the differentiation of submandibular masses based on epidemiological and B-mode ultrasonographic data.
One hundred and eighty-eight patients with submandibular triangle masses were included. Epidemiological and ultrasonographic data of 128 consecutively included patients were assessed and structured in a multimodal algorithm. The diagnostic algorithm was prospectively validated in a further 60 patients.
Single epidemiological and ultrasonographic data do not reliably predict the lesional entity. The multimodal diagnostic algorithm achieved a diagnostic sensitivity/specificity of 100%/100% in sialolithiasis, 44%/100% in benign submandibular gland diseases (BSD), 94%/96% in nodal lymphoma/unspecific lymphadenitis, and 91%/84% in carcinomas. Reduced sensitivity in BSD or specificity in carcinomas increased after intra-operative fresh frozen section in patients suspected for BSD.
多模态诊断算法是一种用于下颌下肿块术前评估的简单诊断工具，可实现一期手术方案。
下颌下肿块的术前评估具有重大临床意义。本研究基于流行病学和B超超声数据评估一种新引入的诊断算法在下颌下肿块鉴别诊断中的应用价值。
纳入188例下颌下三角区肿块患者。对连续纳入的128例患者的流行病学和超声数据进行评估，并构建多模态算法。该诊断算法在另外60例患者中进行前瞻性验证。
单一的流行病学和超声数据不能可靠地预测病变实体。多模态诊断算法在涎石病中的诊断敏感性/特异性为100%/100%，在良性下颌下腺疾病（BSD）中为44%/100%，在结节性淋巴瘤/非特异性淋巴结炎中为94%/96%，在癌中为91%/84%。对于疑似BSD的患者，术中新鲜冰冻切片后，BSD的敏感性降低或癌的特异性增加。
