The Value Of Multimodal Ultrasonography In Differential Diagnosis Of Benign And Malignant Salivary Gland Tumors

Objective:To investigate the value of multimodal ultrasonography in differential diagnosis of benign and malignant salivary gland tumors by comparing the morphological characteristics of multimodal ultrasonography.Methods:The multi-model ultrasound images of 133 lesions were collected from 121 patients who came to the Department of Abdominal Ultrasound of the Affiliated Hospital of Qingdao University for facial tumors from August 2015 to March 2020.The morphological characteristics of 133 salivary gland lesions were analyzed and compared by multimodal ultrasound,and the qualitative characteristic parameters between the two groups were compared byχ~2 test.Parameters as independent variables,and then statistically significant pathological and histological results as the dependent variable,to establish three diagnosis model.ModelⅠ=gray-scale two-dimensional ultrasonic characteristic parameters+color Doppler blood flow classification parameters,ModelⅡ=contrast-enhanced ultrasound imaging characteristic parameters,ModelⅢ=gray-scale two-dimensional ultrasonic characteristic parameters+color Doppler blood flow classification parameters+contrast-enhanced ultrasound imaging characteristic parameters.Logistic regression analysis was used to obtain the equations of each model,and the factors closely related to the differential diagnosis of benign and malignant salivary gland tumors were screened out.The fitting situation of Model 3 was tested by likelihood ratio(LP),and regression parameters were tested by Wald X.In Logistic regression,the prediction probability of Model 3 was pre-stored,and the area under the curve(AUC)of Model 3 was calculated by using receiver operating characteristic curve(ROC)to evaluate the efficacy of each model in the differential diagnosis of salivary gland tumor properties.Results:(1)121 patients were included in this study,a total of 133 lesions,benign tumor 118[116large salivary glands(110 parotid gland,6 submandibular gland),2 minor salivary glands],malignant tumor 15[major salivary glands 13(11 parotid and 2 submandibular gland),minor salivary glands 2],that benign tumor incidence was obviously higher than malignant[(118/133),88.7%vs(15/133),11.3%],especially large incidence of salivary glands[(116/118),98.3%vs(13/15),86.7%],while in small a significantly lower incidence of salivary gland malignant[(2/118),1.7%vs(2/15),13.3%].(2)Multimodal characteristic parameters of ultrasonic morphology in comparison between the two groups,there are seven parameters[shape,boundary,grid sample echo(gray-scale two-dimensional ultrasonic characteristic parameters),enhanced the border,strengthen ring,enhanced volume,direction of contrast agent perfusion(ultrasound imaging characteristic parameters)]differences statistically significant(chi-square=13.422、6.405、4.068、35.273、28.546、36.374、9.288,P value<0.05).(3)The benign and malignant group to establish a diagnosis model after Logistic regression analysis the equation obtained as follows:modelⅠLogistic(P)=0.42-1.29 boundary form-1.41 grid sample-2.17 gridded echo;ModelⅡLogistic(P)=3.75+1.01 enhanced border+1.16 enhancement ring+0.83 volume enhanced+0.66 perfusion direction;ModelⅢLogistic(P)=-2.07+1.84 boundary form+0.51 grid sample-2.39gridded echo+2.67enhanced border+0.97 enhancement ring-0.84enhanced volume+0.96 perfusion direction.There were significant differences among the three diagnostic models(chi-square=25.27,34.78,48.64,P value<0.01),Enhanced border is an effective parameter for differential diagnosis of salivary gland tumors properties(OR=19.07,P=0.049).3 model of regression coefficient>0.1,the P values<0.01,chi-square test model is gradually increasing value(34.78,25.27,48.64),P values decrease gradually,fitting of the model is gradually increased,illustrate the above seven independent variable parameters in general have statistical significance.Three test models,in turn,reduce the negative logarithm likelihood value(68.44,58.93,45.07),shows that as the change of diagnosis model,model and the actual situation of fitting is getting better and better,at the same timeⅢdescription model and the actual situation of fitting is the best.(4)3 deposit model forecast probability of ROC curve drawing shows:benign and malignant group three diagnosis model of AUC increased(0.885,0.852,0.941),at the same time calculation modelⅠ,Ⅱ,Ⅲsensitivity were 66.7%,73.3%,80.0%respectively,specificity of 82.2%,89.8%and 93.2%respectively,the accuracy was 73.2%,82.8%,92.1%respectively,3 model diagnosis efficiency increased gradually,multimodal combined diagnostic performance of the ultrasonic were higher than any independent ultrasonic diagnosis method.Conclusion:(1)Enhanced boundary can be used as an independent predictor in the differential diagnosis of salivary gland tumors.(2)The combined application of multimodal ultrasound can improve the accuracy of the diagnosis of salivary gland tumors,which can provide a reliable theoretical basis for clinical practice.