涎腺导管癌的CT和MR表现

CT and MR imaging findings of salivary duct carcinoma

目的 探讨涎腺导管癌（SDC）的CT和MRI表现.方法 回顾性分析经手术病理证实的20例SDC初诊患者的CT和MRI表现,其中17例行CT平扫和增强扫描,3例行MR平扫和增强检查.观察肿瘤部位、大小、形态、边缘、CT密度或MR信号及强化特征.结果 20例患者肿瘤均为单发,13例位于腮腺,4例位于颌下腺,1例位于舌下腺,2例位于颊部.肿瘤最大径1.5- 7.0 cm,平均（3.5＆#177;0.9）cm.5例病灶呈边缘清晰、光整的类圆形或椭圆形肿块;15例呈边缘不光整、边界不清的不规则分叶状肿块,其中7例病灶周围脂肪间隙模糊、3例侵犯耳前皮肤、2例侵犯咬肌,侵犯咽旁间隙、翼内肌、包绕下颌后静脉各1例.4例密度或信号均匀,16例不均匀.17例CT平扫病灶中,12例为低密度,5例为等密度.7例病灶内见钙化.3例病灶MR T1WI呈等信号,T2WI呈混杂高信号.增强扫描,17例病灶呈明显强化,3例中度强化.12例伴颈部淋巴结肿大.结论 SDC的影像表现缺乏特征性,但CT、MR检查可以准确显示肿瘤累及的范围,为临床治疗提供有价值的信息.

Objective To evaluate the CT and MR imaging findings of salivary duct carcinoma （SDC） in order to enhance the understanding of this rare disease.Methods A retrospective analysis of CT and MRI images was performed in 20 patients （14 males and 6 females,median age 56 years old） with pathologically proved SDC.CT and MR images were evaluated with respect to the following feature factors：location,size,morphology,margin,CT density/ MR signal intensity and enhancement pattern.Results Thirteen lesions were located in parotid gland,4 lesions in submandibular gland,1 lesion in sublingual gland and 2 lesions in the buccal spaces.The maximum diameter of SDC ranged from 1.5 to 7.0 cm,mean （3.5 ＆#177;0.9） cm.Five cases demonstrated round or oval round masses with well-defined margin,15 cases demonstrated irregular masses with ill-defined edge.Among them,the peritumoral fat tissues were infiltrated in 7 cases,the preauricular skin were invaded in 3 cases,the jaw muscles were invaded in 2 cases and the parapharyngeal space,pterygoid muscle,retromandibular vein was invaded in 1 case respectively.Lesions were homogeneous in 4 cases and heterogeneous in 16 cases.Seven lesions showed varied calcifications.Lesions were homogeneous iso-intense in 1 case and heterogeneous iso-intense in 2 cases on T1WI,heterogeneous hyperintense in all cases on T2WI.On post contrast images,lesions demonstrated remarkable enhancement in 17 cases,moderate enhancement in 3 cases.Enlarged cervical lymph nodes were found in 12 cases.Conclusions SDC has nonspecific imaging characteristics.CT and MR examinations can accurately demonstrate the extent of tumor involvement and are helpful to provide more comprehensive information for SDC management.