腮腺粘液表皮样癌的CT诊断及鉴别诊断(附3例报告)

CT Diagnosis and Differential Diagnosis of Mucoepidermoid Carcinoma of the Parotid Gland(3 cases)

目的探讨腮腺粘液表皮样癌的CT特征和诊断价值。方法回顾性分析经手术及病理证实的3例腮腺粘液表皮样癌患者CT表现,均进行CT平扫及增强扫描。结果 1例发生在右侧腮腺,2例为左侧,均发生于浅叶,最大径为1.1-2.1cm,其中1例表现为多结节并融合,另外2例为类圆形结节影,平扫CT值约50-60Hu,相对于腮腺呈稍高密度,边界欠清楚,增强扫描CT值约90-130Hu,1例强化较均匀,1例欠均匀强化,另外1例多结节型可见囊变坏死区。双侧颈动脉鞘区未见明显肿大淋巴结。上述3例CT均误诊为良性病变,考虑腺淋巴瘤或混合瘤。结论腮腺粘液表皮样癌CT表现无特异性,主要为边界欠清,提示肿瘤向周围组织浸润,强化较明显提示肿瘤血供较丰富,这些应考虑到恶性病变可能,最终确诊仍需依靠病理学检查。

Objective To Analyze CT characteristics, and the diagnosis value of CT on mucoepidermoid carcinoma of parotid gland. Methods Retrospective analysis CT manifestations for 3 cases of mucoepidermoid carcinoma of the parotid gland which confirmed by the surgical and pathological, plain and enhanced CT scan were performed. Results One case occurred in the right and two cases in the left of parotid gland, all occurred in the superficial, the maximum diameter was 1.1-2.1cm, one appeared to be multiple nodules and fusion, two were round nodule. CT value was about 50-60Hu when unenhanced, slightly dense was relative to the parotid gland, boundaries were not clear, CT value was around 90-130Hu when enhanced,one cases strengthen more evenly, one case strengthened uneven, one was multiple nodules with cystic necrosis. No significant enlarged lymph nodes in bilateral common carotid artery sheath area. 3 cases werd misdiagnosed as benign lesions, such as adenolymphoma or mixed tumors. Conclusion CT manifestations of mucoepidermoid carcinoma of the parotid gland without specificity, boundary was not clear would prompt tumor-infiltrating surrounding tissue ,significantly enhanced would prompt tumor blood supply was rich, these were prompted for malignant tumor, but still need to rely on pathological examination to confirmed it.