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Comparative Study
. 2020 Sep 16;20(1):107.
doi: 10.1186/s12880-020-00506-y.

The diagnostic value of Superb Microvascular Imaging in identifying benign tumors of parotid gland

Lihui Zhao  1 , Yiran Mao  1 , Jie Mu  1 , Jing Zhao  1 , Fangxuan Li  2 , Sheng Zhang  3 , Xiaojie Xin  1
Affiliations
Comparative Study

The diagnostic value of Superb Microvascular Imaging in identifying benign tumors of parotid gland

Lihui Zhao et al. BMC Med Imaging. .

Abstract

Background: We compared the ultrasound features, superb microvascular imaging (SMI) and micro vessel density (MVD) of pleomorphic adenoma (PA), Warthin's tumor (WT) and basal cell adenoma (BCA) to explore the clinic value of SMI in differential diagnosis of benign tumors of parotid gland.

Methods: The vascular distributions and grade by color doppler flow imaging (CDFI) and SMI, as well as vascular index (VI) of 249 parotid gland masses from 217 patients were analyzed.

Results: The internal echogenicity of BCA are more homogeneous in comparing with WT and PA(P < 0.05). By SMI, the vascular distribution and vascular grade in PA were mainly peripheral (33.1%) and avascular (25.7%), Grade 1 (27.8%) and Grade 0 (25.7%). WT were mainly central (31.3%) and mixed distribution (34.9%), in Grade 3 (37.3%) and Grade 2 (36.2%). BCA was mainly peripheral (33.3%) and mixed distribution (33.3%), in Grade 2 (33.3%) and Grade 3 (33.3%). The overall detection rate of SMI for vascular Grade 2 and 3 was significantly higher than that of CDFI (P < 0.05). Both VI and MVD were lowest in PA, highest in WT (P < 0.001). The VI by SMI was correlated with MVD (P < 0.001). The correlation index between vascular distribution and grade by SMI and MVD were significantly higher than CDFI.

Conclusion: SMI can provide low-velocity blood flow information, which is helpful for the differential diagnosis of common benign tumors of parotid gland, and is expected to be more widely used.

Keywords: Basal cell adenoma; Parotid gland tumors; Pleomorphic adenoma; Superb microvascular imaging; Warthin’s tumor.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig. 1
Fig. 1
Trace the ROI and calculate VI by cSMI of a WT case
Fig. 2
Fig. 2
Represent PA case from right parotid gland. a. conventional ultrasound image; b. CDFI: tiny punctate blood flow, Alder 0;c. mSMI and d. cSMI: short cosh or rod-like blood flow, central distribution, Alder 2; VI by cSMI: 1.4; e. MVD by IHC (× 100); f. MVD by IHC: 18 (× 400)
Fig. 3
Fig. 3
Represent BCA case from left parotid gland. a. Conventional ultrasound image; b. CDFI: punctate or fine rod vessels, Mixed distribution, Alder 3; c. mSMI and d. cSMI: dense streak blood stream, Mixed distribution, Alder 3. VIby cSMI:18.1; e. MVD by IHC (× 100); f. MVD by IHC: 62 (× 400)
Fig. 4
Fig. 4
Represent WT case from right parotid gland. a. Conventional ultrasound image; b. CDFI: 3–4 punctate blood flow, Peripheral distribution, Alder 2; c. mSMI and d. cSMI: Mixed distribution, Alder 3. VIby cSMI:7.4; e. MVD by IHC (× 100); f. MVD by IHC: 38 (× 400)
Fig. 5
Fig. 5
The correlation analysis of MVD and VI. a. The correlation analysis of MVD and VI by cSMI; b. The correlation analysis of MVD and vascular distributions by CDFI; c: The correlation analysis of MVD and vascular distributions by SMI; The correlation analysis of MVD and vascular grade by CDFI; e. The correlation analysis of MVD and vascular grade by SMI
See this image and copyright information in PMC

References

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