Kim K H, Sung M W, Yun J B, Han M H, Baek C H, Chu K C, Kim J H, Lee K S
Department of Otolaryngology--Head and Neck Surgery, College of Medicine, Seoul National University, South Korea.
Auris Nasus Larynx. 1998 Dec;25(4):397-402. doi: 10.1016/s0385-8146(98)00012-1.
Imaging modalities such as CT scan or MRI are frequently employed for the diagnosis of neoplastic lesions in the salivary glands. To evaluate the efficacy of the CT scan and the MRI in differentiating malignant neoplasm from benign lesions, 120 CT scans and 31 MRIs were retrospectively analyzed from 147 patients with salivary gland masses. All images were analyzed focusing on the presence of several relevant features. The pathologic results were matched with radiological features and also tabulated with radiological assessment. For the CT scans, the contour and margin of the lesion and tissue plane obliteration were found to be statistically significant indicators for malignant neoplasms. Among 69 CT scans interpreted as 'benign' by a radiologist, five cases (7%) were histologically diagnosed as 'malignant'. On the other hand, 20 out of 51 CT scans (39%) were misinterpreted as 'malignant'. For MRI, two out of 14 cases (14%) were radiologically misdiagnosed as 'benign' and six out of 17 patients (35%) as 'malignant'. In conclusion, whereas both the CT and MRI showed a similar level of accuracy in evaluation of salivary gland tumors, they showed a considerable tendency of misdiagnosis, especially by interpreting benign tumors as 'malignant'.
诸如CT扫描或MRI等成像方式经常用于唾液腺肿瘤性病变的诊断。为了评估CT扫描和MRI在鉴别恶性肿瘤与良性病变方面的效能,对147例唾液腺肿块患者的120次CT扫描和31次MRI进行了回顾性分析。所有图像均围绕几个相关特征的存在情况进行分析。将病理结果与放射学特征进行匹配,并与放射学评估结果一同列表。对于CT扫描,发现病变的轮廓和边缘以及组织平面消失是恶性肿瘤的统计学显著指标。在放射科医生解读为“良性”的69次CT扫描中,有5例(7%)经组织学诊断为“恶性”。另一方面,51次CT扫描中有20次(39%)被误判为“恶性”。对于MRI,14例中有2例(14%)在放射学上被误诊为“良性”,17例患者中有6例(35%)被误诊为“恶性”。总之,虽然CT和MRI在评估唾液腺肿瘤方面显示出相似的准确性水平,但它们显示出相当大的误诊倾向,尤其是将良性肿瘤误判为“恶性”。