The value of SWE combined with conventional ultrasound examination in the differential diagnosis of benign and ma-lignant parotid gland tumors

JIANG Yanwei; SUN Cheng; CUI Changsheng; FENG Tao; ZHOU Wei; TENG Jianbo; LI Chuanting

doi:10.20258/j.cnki.1006-9011.2025.12.004

Abstract：Objective To explore the value of shear wave elastography(SWE)combined with conventional ultrasound exami-nation in the differential diagnosis of benign and malignant parotid gland tumors.Methods A total of 372 patients with parotid gland tumors were selected.After postoperative histopathological examination,313 cases of benign parotid gland tumors(benign group)and 59 cases of malignant parotid gland tumors(malignant group)were found.All patients underwent routine parotid ul-trasound and SWE examination before the operation.The characteristics of the ultrasound images of the two groups were analyzed.The Young's modulus of parotid gland tissues[average Young's modulus(Emean),maximum Young's modulus(Emax)],the Young's modulus of normal parotid gland tissues around the mass[normal average Young's modulus(nEmean),normal maximum Young's modulus(nEmax)],as well as the ratio of average Young's modulus(rEmean)and the ratio of maximum Young's modulus(rEmax)were compared between the two groups max.The ROC curve was used to analyze the differential diagnostic efficacy of elastic parameters in SWE examination for benign and malignant parotid gland tumors,and to analyze the differential diagnostic efficacy of conventional ultrasound examination and SWE combined with conventional ultrasound examination for benign and ma-lignant parotid gland tumors.Results Benign parotid gland tumors generally had regular morphology,clear boundaries,rela-tively uniform internal echoes,no obvious cystic changes or microcalcification,and the posterior echoes were often enhanced.CDFI showed blood flow grade 0 and 1.Malignant parotid gland tumors often had irregular shapes,unclear boundaries,uneven internal echoes,cystic changes or microcalcification could be seen,and the posterior echoes did not significantly enhance.CDFI showed blood flow grade 2 or 3.The elastic parameters of Emean,Emax,rEmean and rEmax examined in the benign group were all lower than those in the malignant group(all P<0.05).The AUC of SWE examination for elastic parameters of Emean,Emax,rEmean,and rEmax alone and in combination for differentiating benign and malignant parotid gland tumors were 0.832,0.822,0.638,0.657,and 0.956,respectively.The AUC of SWE in differentiating benign and malignant parotid gland tumors by combining the elastic parameters of Emean,Emax,rEmean,and rEmax was higher than that of the four alone(all P<0.05).The accuracy,sensitiv-ity,specificity,positive predictive value and negative predictive value of SWE combined with conventional ultrasound examina-tion in diagnosing benign and malignant parotid gland tumors were significantly higher than those of conventional ultrasound ex-amination(all P<0.05).Conclusion Both conventional ultrasound and SWE examination have relatively high differential diag-nostic value for benign and malignant parotid gland tumors.The combination of the two methods has a higher differential diagnos-tic value for benign and malignant parotid gland tumors.