Assess The Diagnostic Value Of Shear Wave Elastography Combined With Superb Microvascular Imaging In Diagnosing Pleomorphic Adenomaand Adenolymophoma Of Parotid Gland

Objective:To assess the diagnostic value of SWE combined with SMI in diagnosing pleomorphic adenoma and adenolymophoma of glands;to compare the average Young modulus of pleomorphic adenoma and adenolymophoma by SWE;to compare the detectability in vascular distributions and internal vascularity of pleomorphic adenoma and adenolymophoma by CDFI and SMI;and to compare the diagnostic efficiency between conventional two-dimensional ultrasound+CDFI,conventional two-dimensional ultrasound+CDFI+SWE imaging and conventional two-dimensional ultrasound+SMI+SWE imaging for pleomorphic adenoma and adenolymophoma.Methods:Retrospective analysis was performed on 80 patients with parotid gland tumor who met the inclusion criteria and were confirmed by surgery and pathology in the First Affiliated Hospital of Hebei North University from May 2021 to June 2022,including 85 parotid gland tumor(PA=54,AL=31).For each tumor,conventional two-dimensional ultrasound、CDFI、SMI、SWE were performed successively before the surgery.To analyse and compare the size,morphology,boundary,internal echo,posterior echo of pleomorphic adenoma and adenolymophoma by conventional two-dimensional ultrasound;To analyse and compare the average Young modulus of pleomorphic adenoma and adenolymophoma by SWE;To analyse and compare the internal vascularity and the vascular distributions of PA and AL by CDFI and SMI;To analyse and compare the diagnostic efficiency between conventional two-dimensional ultrasound+CDFI,conventional two-dimensional ultrasound+CDFI+SWE and conventional two-dimensional ultrasound+SMI+SWE for pleomorphic adenoma and adenolymophoma by receiver operating characteristic(ROC)curve.Results:(1)There were statistically significant differences in the“internal echo” and the “deformation under pressure”of pleomorphic adenoma and adenolymophoma by conventional two-dimensional ultrasound(P<0.05);(2)The average Young modulus of pleomorphic adenoma was highter than adenolymophoma by SWE(t=4.988,P<0.05);(3)There were statistically significant differences in the internal vascularity of pleomorphic adenoma and adenolymophoma by CDFI(χ2=21.447,P<0.05)and by SMI(χ2=32.690,P<0.05);There were statistically significant differences in the vascular distributions of pleomorphic adenoma and adenolymophoma by CDFI(χ2 =16.325,P<0.05)and by SMI(χ2=26.908,P<0.05).(4)The accuracy of conventional two-dimensional ultrasound+CDFI+SWE was significantly higher than that of conventional two-dimensional ultrasound+CDFI,with a statistically significant difference(χ2=4.542,P<0.05).The specificity(χ2 =9.450,P<0.05)、accuracy(χ2 =12.968,P<0.05)、positive predictive value(χ2 =7.523,P<0.05)and negative predictive value(χ2=4.557,P<0.05)of conventional two-dimensional ultrasound+SMI+SWE was significantly higher than that of conventional two-dimensional ultrasound+CDFI,with a statistically significant difference.The AUC of conventional two-dimensional ultrasound+SMI+SWE imaging technology is maximum(AUC=0.838,95%CI:0.743～0.909,P<0.005),the AUC of conventional two-dimensional ultrasound+CDFI is minimun(AUC=0.596,95%CI: 0.484 ～0.701,P<0.005),and the AUC of conventional two-dimensional ultrasound+CDFI+SWE imaging is in the between(AUC=0.744,95%CI:0.638～0.832,P<0.005).the AUC of the three diagnostic modes for pleomorphic adenoma and adenolymophoma were considered as statistically significant(P<0.05).Conclusion: Combining SWE and SMI could improve the discreminability of pleomorphic adenoma and adenolymophoma,then providing an evidence to assess、diagnose and treat pleomorphic adenoma and adenolymophoma in clinical.