Benzel W, Zenk J, Iro H
Klinik und Poliklinik für Hals-Nasen-Ohrenkranke, Universität Erlangen-Nürnberg.
HNO. 1995 Jan;43(1):25-30.
Color-coded duplex sonography is being increasingly used in the head and neck as another method of diagnosis of, for example, stenosis of arteries or veins or of hemangioma. Moreover, it is of greatest interest in having the ability to differentiate benign from malignant tumors. Since the underlying type of tumor is directly responsible for the (operative) treatment recommended we have investigated histologically proven benign and malignant parotid tumors.
Thirty-six patients (20 women, 16 men, ages 32-66 years) with parotid tumors of unknown histology were examined by means of ultrasound and color-coded duplex sonography. Afterwards, tumors were treated by complete parotidectomy. Histological results were compared postoperatively to the data from the color-coded duplex sonography.
Ultrasound B sonography. All patients were examined with a "Sonoline SI-450" (Siemens), using a 7.5 MHz transducer. Color-coded sonography. The color-coded duplex sonograph used was the Quantum 2000 (Siemens). All investigations were carried out with a 7.5 MHz transducer. Criteria of color-coded duplex sonography. Criteria of the investigation were the qualitative range of color distribution as an indication of vascularization and measurement of perfusion velocity--as far as possible--with mean pulsatility indices. The mean pulsatility index represented peripheral resistance and was proportional to it. All data were collected from three areas in the center of the tumor and tumor margins, respectively. Tumors selected were 17 histologically proven pleomorphic adenomas, 15 adenolymphomas and 4 adenoid cystic carcinomas. RESULTS. In comparing perfusion velocity and mean pulsatility indices, no significant difference was detected between pleomorphic adenomas and adenolymphomas. A loss of perfusion and color was seen in both tumor types, although it occurred more often in the adenolymphomas. These cystic areas in most cases had already been clearly detected with normal B-scan sonography. In two of the four malignancies there were no obvious differences to the benign tumors. In the other two cases of malignancy a pronounced vasularization was detected and, therefore, an extended distribution of color. This finding together with decreased perfusion velocity and low mean pulsatility indices indicated low peripheral resistance.
At this point it is not possible routinely to utilize color-coded duplex sonography as an accurate indicator of underlying pathology of parotid neoplasms. A differentiation among different types of benign tumors is not possible using the technique, nor can malignancies be recognized definitively by this method.
彩色编码双功超声在头颈部的应用越来越广泛，可用于诊断动脉或静脉狭窄、血管瘤等疾病。此外，其区分良性肿瘤和恶性肿瘤的能力备受关注。由于肿瘤的潜在类型直接决定了推荐的（手术）治疗方式，我们对经组织学证实的腮腺良性和恶性肿瘤进行了研究。
36例（20例女性，16例男性，年龄32 - 66岁）组织学类型不明的腮腺肿瘤患者接受了超声和彩色编码双功超声检查。之后，肿瘤通过腮腺全切术进行治疗。术后将组织学结果与彩色编码双功超声检查数据进行比较。
超声B型检查。所有患者均使用“Sonoline SI - 450”（西门子）超声仪，配备7.5MHz探头进行检查。彩色编码超声检查。使用的彩色编码双功超声仪为Quantum 2000（西门子）。所有检查均使用7.5MHz探头。彩色编码双功超声检查标准。检查标准为彩色分布的定性范围，以指示血管化情况，并尽可能测量灌注速度及平均搏动指数。平均搏动指数代表外周阻力，与之成正比。所有数据分别从肿瘤中心和肿瘤边缘的三个区域采集。选取的肿瘤包括17例经组织学证实的多形性腺瘤、15例腺淋巴瘤和4例腺样囊性癌。结果。在比较灌注速度和平均搏动指数时，多形性腺瘤和腺淋巴瘤之间未检测到显著差异。两种肿瘤类型均出现灌注和颜色缺失，尽管在腺淋巴瘤中更为常见。大多数情况下，这些囊性区域在普通B型超声检查中已能清晰检测到。4例恶性肿瘤中有2例与良性肿瘤无明显差异。在另外2例恶性肿瘤中，检测到明显的血管化，因此颜色分布范围扩大。这一发现连同灌注速度降低和平均搏动指数较低表明外周阻力较低。
目前，彩色编码双功超声尚不能常规用作腮腺肿瘤潜在病理类型的准确指标。该技术无法区分不同类型的良性肿瘤，也不能通过此方法明确识别恶性肿瘤。
