国际口腔医学杂志

国际口腔医学杂志 ›› 2022, Vol. 49 ›› Issue (1): 60-65.doi: 10.7518/gjkq.2022011

• 论著 • 上一篇    下一篇

超声灰度直方图对多形性腺瘤与腺淋巴瘤鉴别诊断效能的初步研究

夏飞飞(),秦文娟,冯佳,周旭阳,孙二灿,黎昌学()   

  1. 石河子大学医学院第一附属医院口腔科 石河子 832008
  • 收稿日期:2021-04-12 修回日期:2021-09-22 出版日期:2022-01-01 发布日期:2022-01-07
  • 通讯作者: 黎昌学
  • 作者简介:夏飞飞,硕士,Email： 1400977438@qq.com

Value research on differential diagnosis of pleomorphic adenomas and adenolymphoma by histogram analysis of ultrasound gray

Xia Feifei(),Qin Wenjuan,Feng Jia,Zhou Xuyang,Sun Ercan,Li Changxue()   

  1. Dept. of Stomatology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832008, China
  • Received:2021-04-12 Revised:2021-09-22 Online:2022-01-01 Published:2022-01-07
  • Contact: Changxue Li

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摘要： 目的 探讨超声灰度直方图对腮腺多形性腺瘤与腺淋巴瘤的鉴别诊断价值。方法 对18例多形性腺瘤（PA）与 13 例腺淋巴瘤（AL）患者的术前超声图像进行灰度直方图分析,比较PA与 AL 组患者直方图的均值、方差、偏度、峰度及第 1、10、50、90、99 百分位数的差异。应用受试者工作特征（ROC）曲线计算各参数的鉴别诊断效能。结果 PA组的方差高于AL组,偏度和峰度值低于AL组,其差异具有统计学意义（P<0.05）;但2组的均值、第1、10、50、90及99百分位数的差异均无统计学意义（P>0.05）。ROC曲线分析显示,峰度值最具鉴别诊断效能,曲线下面积（AUC）为0.744（P=0.022）,最佳临界值为1.71,敏感度为76.9%,特异度为61.1%,约登指数为0.380。方差的鉴别诊断效能、最佳临界值、敏感度、特异度及约登指数分别为0.735（P=0.028）、864.94、72.2%、76.9%及0.491。结论 超声灰度直方图对PA与AL具有一定的鉴别诊断价值。

关键词: 多形性腺瘤, 腺淋巴瘤, 直方图, 超声灰度, 超声检查

Abstract: Objective To investigate the value of gray-scale histogram in the differential diagnosis of pleomorphic Adenoma and Adenolymphoma of parotid gland.Methods The preoperative ultrasound images of 18 patients with pleomorphic Adenoma (PA) , and 13 patients with Adenolymphoma (AL) were analyzed for imaging gray-scale histograms parameters (mean, variance, skewness, Kurtosis, 1st, 10th, 50th, 90th, 99th percentiles).The Receiver Operating Characteristic (ROC) curve was used to calculate the differential diagnostic efficiency of each parameter.Results The variance of PA group was higher than that of AL group, but the skewness and kurtosis were lower than that of AL group, and the difference was statistically significant (P<0.05). The value of mean, the 1st, 10th, 50th, 90th and 99th percentiles between the two group had no significant difference (P>0.05). The analysis of ROC curve showed that the Kurtosis was the most effective parameter for differential diagnosis. The AUC was 0.744 (P=0.022), the best critical value was 1.71, the sensitivity was 76.9%, the specificity was 61.1%, and the yoden index was 0.380. Besides, The AUC, optimal critical value, sensitivity, specificity and Yoden index of variance were 0.735 (P=0.028), 864.94, 72.2%, 76.9% and 0.491 respectively.Conclusion The ultrasonic gray histogram has a certain value in the differential diagnosis between PA and Al.

Key words: pleomorphic adenoma, adenolymphoma, histogram, ultrasonic gray scale, ultrasonic examination

图1

右侧腮腺多形性腺瘤 A：右侧腮腺病灶超声影像;B：选择病灶区ROI;C：病灶区ROI直方图;D：病理检查示右侧腮腺多形性腺瘤（苏木精-伊红染色 × 100）。"

图2

右侧腮腺腺淋巴瘤 A：右侧腮腺病灶超声影像;B：选择病灶区ROI;C：病灶区ROI直方图;D：病理检查示右侧腮腺腺淋巴瘤（苏木精-伊红染色 × 100）。"

表 1

PA与AL灰度直方图参数比较"

参数 PA组 AL组 t/z值 P值
均值 43.14（25.99、59.01）* 23.08（19.19、54.73）* -1.601 0.109
方差 1072.75±391.14 755.72±263.39 2.531 0.017
偏度 1.10±0.64 1.82±1.12 -2.269 0.031
峰度 1.55（0.60、3.43）* 3.94（1.64、7.85）* -2.282 0.022
第1百分位数 1（1、1）* 1（1、2）* -1.844 0.065
第10百分位数 1.5（1、1.5）* 1（1、19.5）* -0.285 0.776
第50百分位数 33（15.5、54.5）* 13（4、52.5）* -1.502 0.133
第90百分位数 85.83±29.24 71.23±28.78 1.381 0.178
第99百分位数 138.06±32.72 12.00±26.95 1.629 0.114

图3

方差鉴别诊断PA与AL的ROC曲线"

图4

偏度和峰度鉴别诊断PA与AL的ROC曲线"

表2

直方图鉴别PA与AL的 ROC曲线分析结果"

参数 AUC P值 临界值 敏感度 特异度 约登指数
方差 0.735 0.028 864.94 0.722 0.769 0.491
偏度 0.705 0.055 1.949 0.462 0.994 0.406
峰度 0.744 0.022 1.710 0.769 0.611 0.380
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