常规MRI联合DWI在腮腺常见肿瘤中的诊断价值

Value of routine MRI in combination with DWI in the diagnosis of parotid gland tumors

目的:探讨常规MRI联合DWI对腮腺常见肿瘤的诊断价值。方法:回顾性分析经病理证实的62例腮腺肿瘤的MRI图像,根据其DWI图行ADC图重建,测量肿瘤的ADC值。按发病率将62例病例分成3组:多形性腺瘤、腺淋巴瘤、恶性肿瘤。多形性腺瘤31例,全部单发;腺淋巴瘤19例,9例单发,10例多发,共30个病灶;恶性肿瘤12例,3例淋巴瘤多发,其余均为单发,共18个病灶。比较分析3种肿瘤的ADC值。结果:多形性腺瘤和腺淋巴瘤多发生于腮腺浅叶(43个,70.5%),肿瘤边界多清楚,体积一般较恶性肿瘤小;恶性肿瘤位于深叶者8个(44.4%),边界清楚或不清楚,多伴有颈部淋巴结肿大(10例,83.3%)。多形性腺瘤及恶性肿瘤平均ADC值均高于腺淋巴瘤(P=0.000、0.002),且多形性腺瘤平均ADC值高于恶性肿瘤(P=0.001)。结论:腮腺肿瘤的常规MRI征象具有一定特点,联合DWI能为腮腺常见肿瘤的诊断及鉴别诊断提供更多依据。

Objective：To evaluate the value of routine MRI in combination with DWI in the diagnosis of common parotid gland tumors.Methods：MRI and DWI of 62 cases with common parotid gland tumors confirmed by histopathology were analyzed retrospectively,the ADC values of the tumors were measured.These 62 cases were divided into 3 groups including pleomorphic adenoma,adenolymphoma and malignant tumor.Of the 62 patients,there were pleomorphic adenomas（31 patients,all were solitary lesion）,adenolymphomas（19 patients,30 lesions,with 9 solitary lesion and 10 multiple lesions）,and malignant tumors（12 patients,18 lesions,with 3 lymphoma showing multiple lesions and the rest were solitary lesion）.The ADC values of these 3 groups were compared and analyzed.Results：Most of the pleomorphic adenomas and adenolymphomas located within superficial lobe（43 lesions,70.5%）,with well-defined margin and their volumes were smaller than malignant tumors.8 malignant tumors（44%） located within deep lobe,with ill-/well-defined margin,10 patients（83.3%） had associated lymphadenopathy of neck.The mean ADC value of pleomorphic adenoma and malignant parotid tumor were significantly higher than that of adenolymphoma（P=0.000,0.002）.The mean ADC value of pleomorphic adenoma was significantly higher than that of malignant parotid tumor（P=0.001）.Conclusion：Certain MRI characteristics of parotid tumors could be assessed on MRI,routine MRI in combination with DWI can provide more information in the diagnosis and differential diagnosis of common parotid tumors.