Schick S, Steiner E, Gahleitner A, Böhm P, Helbich T, Ba-Ssalamah A, Mostbeck G
Department of Radiology, University Hospital Vienna, Austria.
Eur Radiol. 1998;8(8):1462-7. doi: 10.1007/s003300050576.
To establish criteria for the differentiation of benign and malignant tumors of the parotid gland using color Doppler sonography (CDS) and pulsed Doppler sonography (PDS) we examined 37 patients with parotid tumors by gray-scale ultrasound, CDS, and PDS. Tumor vascularization displayed by CDS was graded subjectively on a 4-point scale (0 = no vascularization, 3 = high vascularization). From the Doppler spectrum, the highest systolic peak flow velocity, the resistive index (RI), and the pulsatility index (PI) were calculated. There were 11 malignant and 26 benign tumors. Tumor vascularization by CDS was grade 0 or 1 in 88.5% of benign lesions, whereas it was grade 2 or 3 in 82% of malignant lesions (P < 0.0001). The highest systolic peak flow velocity was statistically significantly higher in malignant lesions than in benign lesions. Using a threshold systolic peak flow velocity of 25 cm/s, sensitivity was 72% and specificity was 88% for the detection of a malignant tumor. Evaluation of tumor vascularization by CDS and PDS cannot differentiate between benign and malignant parotid tumors with certainty. However, high vascularization and high systolic peak flow velocity in tumor vessels should raise the suspicion of malignancy, even if tumor morphology on gray-scale sonography indicates a benign lesion.
为了建立使用彩色多普勒超声（CDS）和脉冲多普勒超声（PDS）鉴别腮腺良恶性肿瘤的标准，我们对37例腮腺肿瘤患者进行了灰阶超声、CDS和PDS检查。CDS显示的肿瘤血管化程度采用4分主观评分（0=无血管化，3=高度血管化）。从多普勒频谱计算出最高收缩期峰值流速、阻力指数（RI）和搏动指数（PI）。其中有11例恶性肿瘤和26例良性肿瘤。CDS显示的肿瘤血管化在88.5%的良性病变中为0级或1级，而在82%的恶性病变中为2级或3级（P<0.0001）。恶性病变的最高收缩期峰值流速在统计学上显著高于良性病变。使用25cm/s的收缩期峰值流速阈值，检测恶性肿瘤的敏感性为72%，特异性为88%。通过CDS和PDS评估肿瘤血管化不能确定地区分腮腺良恶性肿瘤。然而，即使灰阶超声显示的肿瘤形态提示为良性病变，肿瘤血管的高度血管化和高收缩期峰值流速也应引起对恶性肿瘤的怀疑。
