腮腺腺淋巴瘤的CT诊断

CT diagnosis of adenolymphomas in parotid gland

目的探讨腮腺腺淋巴瘤的CT表现,提高对本病的认识。方法回顾性分析经手术病理证实的18例腮腺腺淋巴瘤患者的临床资料和CT表现,各例均行平扫和多期增强扫描。结果 18例患者中,男性15例(83.3%),平均年龄57岁,有长期吸烟史15例(83.3%)。13例(72.2%)表现为耳前下方无痛性肿块。CT检查共发现病灶33个,单发9例,单侧或双侧多发7例(38.9%),病灶位于浅叶后下部者20个(60.6%)。26个病灶呈类圆形或椭圆形(78.8%),29个病灶(87.9%)边缘清晰规整,12个病灶(36.4%)平扫密度均匀。增强扫描29个病灶(87.9%)呈中度或明显强化,9个病灶(27.3%)均匀强化,31个病灶(93.9%)强化峰值出现在动脉期,静脉期和延迟期强化减退。10个病灶(30.3%)出现"贴边血管征"。结论 50岁以上、有长期吸烟史的男性患者,病灶位于腮腺后下部,边缘清晰,早期明显强化,特别是多发病灶,应首先考虑腺淋巴瘤的诊断。

Objective To study the CT imaging features of parotid gland adenolymphom in order to improve the cognition.Methods The clinical data and CT findings of 18 patients with parotid gland adenolymphom confirmed by pathology were retrospectively analyzed.All cases were performed plain and multi-phase enhanced scan.Results Among 18 patients with average age of 57 years,15（83.3%） patients were male;15（83.3%） patients had a long-term smoking history;13 patients show the symptom with painless tumor below the front of ear.33 lesions were found by CT among 18 cases,with single lesion in 9 cases,unilateral or bilateral multiple lesion in 7 cases（38.9%）,20 lesions located in the lower-back superficial pole of the parotid gland（60.6%）.26 lesions showed the form of roundness or oval（78.8%）.29 lesions had clear and smooth border（87.9%）.12 lesions were presented as homogeneous density（36.3%）.29 lesions showed moderate or significant enhanced（87.9%）.9 lesions showed enhancement with homogeneous density（27.3%）.31 lesions showed maximum enhancement in arterial phase and rapidly faded away in the following venous phase and delay phase（93.9%）.10 lesions were found adjoined to the vessel（30.3%）.Conclusions Adenolymphoma of parotid gland should be first considered when the male patient over 50 years with long-term smoking habit has lesions located in the posterior and inferior pole with well defined margin,marked enhancement in early phase especially when the lesion is multiple.