Evaluation of real-time qualitative sonoelastography of focal lesions in the parotid and submandibular glands: applications and limitations.
OBJECTIVE
To evaluate qualitative ultrasound elastography for focal salivary gland masses identified during routine clinical practice.


METHODS
Sixty-five parotid or submandibular masses in 61 patients underwent real-time qualitative ultrasound elastography and were scored on colour-scaled elastograms in terms of their stiffness relative to adjacent normal salivary parenchyma from ES 1 (soft) to ES 4 (stiff). This was correlated with diagnosis from aspiration cytology or histology.


RESULTS
There were 29 Warthin's tumours (WTs), 23 pleomorphic adenomas (PAs), 2 adenoid cystic carcinomas, 1 adenosquamous carcinoma, 1 nodal metastasis from nasopharyngeal carcinoma, 1 lymphoma (2 deposits), 3 Kuttner tumours and 4 cases of Kimura's disease. ES scores showed clustering according to pathological condition. In this respect, PAs were firmer than WTs (P < 0.004, Fisher's exact test). Nine, 19, 14 and 17 of the benign masses and 0, 1, 2 and 3 of the malignant masses were ES 1, 2, 3 and 4 respectively. All three primary salivary malignancies were ES 4 compared with 1/29 WTs and 16/23 PAs.


CONCLUSIONS
These preliminary findings suggest that qualitative real-time ultrasound elastography, although an ancillary technique to conventional ultrasound in the salivary glands, is likely to have a poor ability to discriminate benign lesions (particularly PAs) from malignant disease.
Bhatia
Kunwar S S
KS
Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR China.
Rasalkar
Darshana D
DD
Lee
Yim-Ping
YP
Wong
Ka-Tak
KT
King
Ann D
AD
Yuen
Hok-Yuen
HY
Ahuja
Anil T
AT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003199:Computer Systems; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000000981:diagnostic imaging*; D010307:Parotid Neoplasms / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013363:Submandibular Gland / Q000000981:diagnostic imaging*; D013365:Submandibular Gland Neoplasms / Q000000981:diagnostic imaging*; D055815:Young Adult
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