喉部非上皮性良性肿瘤的CT诊断

CT diagnosis of the non-epithelial benign tumors of the larynx

目的研究分析喉部非上皮性良性肿瘤的 CT 表现,并探讨其在临床诊断和治疗中的价值。方法对39例经手术、病理或临床综合诊断证实(主要为喉镜)的喉部非上皮性良性肿瘤均行 CT 检查。平扫10例、增强扫描31例,其中平扫+增强2例。结果血管瘤22例,伴有静脉石9例,与周围肌肉密度相比,8例平扫呈等密度,14例增强扫描显示中度至明显强化9例,无明显强化5例。神经源性肿瘤6例,其中神经鞘瘤5例,平扫时呈低或中等密度,增强后均匀或不均匀强化,另1例神经纤维瘤平扫显示均匀低密度。软骨瘤3例,增强扫描显示不均匀强化。多形性腺瘤3例,中度至明显强化,其中1例明显囊性变。脂肪瘤2例,均为不强化的低密度。淋巴管瘤、平滑肌瘤和纤维瘤各1例,其中淋巴管瘤增强后无强化;平滑肌瘤增强扫描后中等至明显强化,密度均匀;纤维瘤不均匀强化伴有囊性变。结论 CT 可清楚显示喉部非上皮性良性肿瘤的形态、范围大小和密度特征,为诊断定性和临床治疗提供重要依据。

Objective To investigate CT findings of the non-epithelial benign tumors of the larynx and their value in diagnosis and treatment. Methods Thirty-nine patients with non-epithelial benign tumors of larynx were examined with CT before treatment. Results Twenty-two cases with hemangioma displayed phebolithes in 9 cases, plain CT in 8 cases showed isodensity with respect to muscle near them and enhanced CT in 14 cases showed moderate to marked enhancement（9 cases） and no contrast enhancement（5 cases）. Among 6 cases of neurogenic tumor, neurilemmoma （5 cases） presented as low to intermediate density on plain CT scan（ 1 case） and enhancement with homogeneous or inhomogeneous after enhanced CT, another case of neurofibroma presented as low density with homogeneous on plain CT imaging. Chondroma（3 cases） showed enhancement with inhomogeneous on enhanced CT scan. Pleomophic adenoma （ 3 cases） showed moderate to marked enhancement and one of the three cases presented as marked cystic degeneration. Lipoma（2 cases）demonstrated low density with no contrast enhancement. Lymphangioma, leiomyoma and fibroma（eaeh has 1 case） displayed no contrast enhancement （lymphangioma） and moderate to marked enhancement（leiomyoma and fihroma） on enhanced CT scans. Conclusion CT can definitely display the shape, range and density of the tumors in larynx and provide information for diagnosis and treatment.