涎腺腺泡细胞癌的CT和MR表现

CT and MR imaging findings of acinic cell carcinoma in salivary gland

目的探讨涎腺腺泡细胞癌（ACC）的CT和MRI表现，以提高对该病的影像诊断水平。方法回顾性分析经手术病理证实的20例ACC的CT和MR表现（14例行CT检查，6例行MR检查）。20例中男7例、女13例，年龄12～73岁，中位年龄44岁。对肿瘤的部位、大小、形态、边缘、CT密度或MR信号及强化形式进行分析。结果肿瘤位于腮腺12例，左侧上颌窦2例，右侧颌下腺、左侧咽旁间隙、左侧颞下窝、左侧面颊部、右侧鼻腔、左硬腭各1例。病灶最大径≤3cm者16例，呈边缘光整、膨胀性生长的类圆形或椭圆形肿块；〉3cm者4例，呈边缘不光整、侵袭性生长的不规则分叶状肿块，其中3例破坏上颌窦窦壁骨质，1例侵犯耳前皮肤。密度（信号）均匀6例，不均匀14例。14例CT平扫病灶呈稍低密度11例，等密度3例；6例MR病灶信号T1WI呈等信号，T2WI呈混杂高信号。19例增强后病灶呈明显强化14例、中度强化2例、轻度强化3例。结论ACC的影像学表现多样，缺乏特征性，CT、MR检查可以准确显示肿瘤累及的范围，为临床制定治疗策略提供客观依据。

Objective To explore the CT and MR imaging findings of acinic cell carcinoma （ACC） in salivary gland and enhance the diagnosis of this rare disease. Methods The CT and MR imaging characteristics of 20 patients （7 males and 13 females, median age 44 years old） with pathologically proved ACC were retrospectively reviewed. CT and MR images were evaluated in relation to the following： location, size, morphology, margin, CT density/MR signal intensity and enhancement pattern. Results Twelve lesions were located in parotid gland, two lesions in maxillary Sinus, and one lesion in submandibular, parapharyngeal, infratemporal fossa, buccal, nasal cavity, and hard palate respectively. The size of lesions were 0. 7-5.8 cm. Sixteen lesions less than 3 cm in size demonstrated round or oval round masses with well defined margin. Four lesions more than 3 cm in size demonstrated irregular masses with unclear margin. Among them, bony destruction of the wall of the maxillary sinus was noted in 3 cases, and the preaurieular skin was invaded in 1 case. The densities （ signal intensity） were homogeneous in 6 cases and heterogeneous in 14 cases. Lesions were slightly low density in 11 case and isodensity in 3 cases on CT plain scan. Lesions were homogeneous isointense in 2 cases and heterogeneous isointense in 4 cases on T1WI, heterogeneous hyperintense in all cases on T2WI. On post contrast images,lesions demonstrated remarkable enhancement in 14 cases,moderate enhancement in 2 cases and mild enhancement in 3 cases. Conclusions The imaging characteristic of ACC were nonspecific. CT and MR could accurately detect the extent of tumor involvement and was helpful to provide more comprehensive information for the strategy of clinic therapy.