Preliminary Studies Of Ultrasound Lesion L/S,UGSR And Histogram Analysis To Identify Parotid Malignancy,Pleomorphic Adenoma And Adenolymphoma

Object: To investigate the value of long and short diameter ratio(L/S),ultrasonic gray ratio(UGSR)and ultrasound gray histogram analysis in the differential diagnosis of parotid tumors.Methods: Imaging features,L/S,UGSR and ultrasound histograms of 17 parotid gland Malignant tumor(MT),48 pleomorphic adenoma(PA)and 39 adenolymphoma(AL)patients with a clear pathological diagnosis were analysed.Tumor morphology,L/S,UGSR and 9 first-order texture features in the histogram of MT,PA,AL were compared.The diagnostic performance of statistically different parameters was evaluated by analyzing the area under the ROC curve(AUC),Youden index,sensitivity and specificity.Results:(1)Boundary,L/S and UGSR were significant differences between MT,PA and AL(P<0.05).Pairwise comparisons showed that MT boundaries are more unclear than PA and AL boundaries(P <0.001);The L/S value of AL is higher than the L/S value of PA(P=0.018);The UGSR of MT was higher than PA(P=0.002)and AL(P=0.001),and the UGSR of PA was higher than AL(P=0.029),and the difference was also statistically significant.When the UGSR alone was used to identify MT from PA and AL,the AUC(95%CI)values were 0.770(0.640-0.898)and 0.771(0.657-0.887)respectively,the sensitivity was 80.8%and 82.4%,and the specificity was 61.7% and 64.1%,respectively.When UGSR combined with boundary features in the differential diagnosis of MT from PA(AUC(95%CI)=0.853(0.746-0.960))and AL(AUC(95%CI)=0.885(0.797-0.972)),AUC values reached a good range,sensitivity and specificity values are greater than 80%.The AUC(95%CI)of L/S was 0.698(0.588-0.808),almost acceptable range.When L/S is combined with UGSR in the differential diagnosis of PA and AL,the AUC(95%CI)was0.741(0.638-0.845),with a sensitivity and specificity of 74.4% and 68.7%,respectively.(2)The analysis revealed statistically significant differences in mean and skewness between the PA and AL groups(P<0.001),as well as mean and Perc90 th between the MT and AL groups(P<0.001).The mean value of AL was lower than that of MT(P<0.001)and PA(P<0.001);the skewness value of AL is higher than that of PA(P<0.001);MT Perc90 th value higher than AL(P=0.045).Mean had good diagnostic efficacy in identifying MT and AL(AUC(95%CI)=0.822(0.700-0.943))and PA and AL(AUC(95%CI)=0.802(0.705-0.899)).AUC(95%CI)reached 0.835(0.714-0.955)when MT and AL were identified by Mean combined with Perc90 th,sensitivity and specificity were 96.8% and 58.8%,respectively.AUC(95%CI)reached 0.823(0.732-0.914)when PA and AL were identified by Mean combined with Skewness with sensitivity and specificity of 100% and 52.3%,respectively.Conclusion: The ultrasound image lesion L/S,UGSR values and ultrasound image gray-scale histogram analysis are valuable for the preoperative differential diagnosis of parotid gland Malignant tumor,pleomorphic adenoma and adenolymphoma.