| Objective: 1.To improve the accuracy of ultrasonic diagnosis by analyzing the difference of ultrasound imaging performance between parotid and submandibular gland pleomorphic adenoma(PA). 2.Discussion the similarities and different biological behavior between the parotid and submandibular glands PA by analyzing the differences performance of Conventional ultrasound(US) and Contrast-enhanced ultrasoundand(CEUS) and the reasons for these differences arising, and then provide more useful information about the PA in the tissue components and wether the envelope is complete to clinicians before surgery.Methods: Retrospectively analyzed the US、Color Doppler Flow Imaging(CDFI) and CEUS exams of 118 cases of salivary gland PA(43 cases of submandibular gland PA, 75 cases of parotid PA). Compareed the differences of biological behavior(including growth, recurrence and so on) between parotid gland PA and submandibular gland PA parotid by comparison the differences image performance of the two group.Results:Observed from the US exams that:1. general analysis: 118 cases of salivary gland PA, 50 cases are male(42.37%), 68 cases are fomale(57.63%), ranging in age from 13 to 74 years old, the average age was 40.55 ± 15.30 years old, the majority of patients with no symptoms, found that lesions accidentally and then went to the hospital. Among the all cases, there were 75 cases of the salivary gland PA with an average age of 40.3 ± 14.70 years old, and the ratio of male to female were 0.83: 1; 43 cases of submandibular gland PA with an average age of 41.14 ± 16.46 years old, and the ratio of male to female were 0.59: 1; the differences of the age and sex were not statistically significant between the two groups,(P>0.05). The size of the 118 salivary gland lesions were 3.9x2.4mm to 60.0x38.4mm, the average diameter(25.6±10.5) mm, the average longitudinal diameter(18.5±8.2) mm. There was significant difference between ultrasound results and surgical recorded(P<0.05); it means that the results of ultrasonicmeasurement and the actual size of the tumor are equal. 2. Most of the PA showed: clear boundary hypoechoic nodules, regular or irregular, which could be seen anechoic areas or point sheet hyperechoic, posterior acoustic enhancement in two-dimensional ultrasound. Among them, there were significant differences between parotid PA and submandibular gland PA in the characteristics of irregular shape, uneven echo and anechoic areas of PA, respectly(P<0.05), while there was no statistically significant in the features of the clear boundary, calcification and A / T value(P>0.05). 3. In CDFI:Alder flow grade were mostly shown as 1 or 2 flow signals in both of the parotid and submandibular gland PA, there were no statistical significance between them(P> 0.05). 4. In CEUS:submandibular gland PA and parotid PA mostly showed slow fill-in, centripetal, inhomogeneous enhancement, after enhancing boundary was cleared and the size unchanged, these characteristics between the two groups was not statistically significant(P>0.05); but with no enhancement area, discontinuous ring enhancement and high enhancement were more common in the submandibular gland PA,comparison in these characteristics there were statistically significant between the them(P<0.05). 5. Until January 2016, 1 to 5 year follow-up after surgery in all 118 cases of PA were followed up 95 cases(80.5%), loss in 23(19.5%). There were five 5 cases of recurrence, all occurred in the parotid gland. In CEUS, there were no statistical significance in the features of enhancement time, mode, enhanced uniform or not, ring enhancement continuous or not, whether had no enhanced area between the recurrence group and non-recurrence group(Fisher’s exact value>0.05), enhanced strength between the two groups was statistically significant, patients with recurrent group showed low enhancement(Fisher’s exact value<0.05); there was statistically significant in enhanced strength between the two groups, recurrence group were all low enhancement.Conclusion: Because of the different parts, the sonographic features of the PA are not the same. Researched on the different sonographic findings of the PA in different places, really hulpfull for preoperative understanding of PA tissue components and whether the envelope is complete, etc. This information is very useful for clinicians, and these can help provide surgical options and prognosis for the clinician. |
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