腮腺及其周围间隙MRI解剖标志对肿瘤定位的价值

MRI anatomic marks for the location of tumors in the parotid and related spaces

目的评价腮腺及其周围间隙ＭＲＩ解剖标志对肿瘤定位的价值。方法１１０例累及腮腺及其周围间隙的肿瘤均行ＳＥ序列检查，１０７例经手术和病理证实，３例颈动脉体瘤经血管造影证实。用Ｔ１加权作为观察ＭＲＩ解剖标志的主要方法。结果翼内肌、咽旁间隙、颈内动脉和颈内静脉移位方向可作为嚼肌间隙、咽旁间隙、颈动脉间隙肿瘤的定位标志；腮腺深部与肿瘤之间有无脂肪平面是鉴别腮腺深部内外肿瘤的较可靠方法；腮腺内面神经及其主导管和下颌后静脉等经路上的解剖标志对肿瘤深、浅部定位的正确率为９４．９％；跨间隙生长的肿瘤均为恶性。

Purpose To evaluate the MRI anatomic marks for the location of tumors in the parotid and related spaces. Methods 110 patients with tumors invading the parotid and related spaces were studied with MRI using spin echo T 1WI. 107 patients were confirmed surgically and pathologically, and 3 patients with carotid body tumors proved by angiography. Results MRI could differentiate tumors in masticator, parapharyngeal and carotid spaces according to the displacement of the medial pterygoid muscle, fat of parapharyngeal space, internal carotid artery and internal jugular vein. The best method for differentiating a deep lobe parotid mass and extraparotid lesion was to visualize a fat plane between the deep lobe and the mass. The position of tumors in the parotid was determined on the basis of superficial or deep relationship of the tumors to the facial nerve, main duct and retromandibular vein. The accuracy was 94.9%. All tumors crossing the boundaries of the compartments were malignant. Conclusion The MRI anatomic marks can provide useful information on the origin of tumors, which is important for clinical management and surgical planning.