多层螺旋CT增强扫描对腮腺肿瘤的诊断价值

Multislice CT enhancement scanning value to the diagnosis of parotid gland tumors

目的探讨多层螺旋CT增强扫描对腮腺肿瘤的诊断的价值以及其强化特点。方法对我院7年间经手术病理证实的98例腮腺肿瘤共109个病灶进行回顾性研究,所有患者术前均行螺旋CT平扫+增强检查,分析评价其CT形态及分布特征,观察病灶多期动态增强变化特征(强化方式及强化程度)。结果 98例腮腺肿瘤患者经手术病理学诊断为良性肿瘤84例(85.7%),包括多形性腺瘤56例,腺淋巴瘤24例,基底细胞瘤4例;恶性肿瘤14例(14.3%),其中粘液表皮样癌5例,腺样囊性癌4例,腺泡细胞癌4例,淋巴上皮癌1例;CT平扫显示腮腺各类肿瘤的CT值无显著性差异(P>0.05);增强特点,多形性腺瘤表现为渐进性强化,腺淋巴瘤表现为速升速降强化方式,基底细胞瘤表现为速升持续强化,恶性肿瘤表现为渐进并延迟强化,腺淋巴瘤动脉期CT值明显高于较其他类型的肿瘤,差异有统计学意义(P<0.05);病灶分布部位、边缘、侵袭性等方面也具有显著统计学意义。结论通过螺旋CT观察腮腺肿瘤病灶在各期增强扫描不同强化特点及结合病灶不同部位、形态、边缘、侵袭性等方面,可进一步提高腮腺肿瘤定性诊断的准确性,为临床合理治疗提供更加科学、客观的依据。

Objective To investigate the value of spiral CT dynamic enhanced scan diagnosis of gland tumors and its strengthening characteristics. Methods 98 cases of parotid tumors （total 109 lesions） confirmed pathologically in the hospital seven years were retrospectively studied,all patients underwent spiral CT scan and enhanced examination,analysis and evaluate the CT morphology and distribution of observed lesions muhi-phase dynamic enhanced liquidity feature （enhanced mode and degree of enhancement）. Results 98 cases of parotid tumors by surgery pathology diagnosis of benign 84 cases （85.7%）,including 56 cases of pleomorphic adenoma, adenolymphoma 24 cases,4 cases of basal cell carcinoma; 14 cases of malignant tumors（14.3%）,including 5 cases of mucoepidermoid carcinoma, adenoid cystic carcinoma 4 cases, 4 cases of acinar cell carcinoma ,lymphoepithelial carcinoma lcase;CT scan shows CT values of various types of tumors of the parotid gland without significant difference （P〉0.05）;Enhanced features：Pleomorphic adenoma characterized by progressive strengthening,adenolymphoma liter downhill speed performance enhancement pattern, basal cell carcinoma showed rapid rise continued to strengthen, and malignant tumor characterized by gradual and delay to strengthen, adenolymphoma arterial phase CT was significantly higher than other types of tumors, the difference was statistically significant （P〈0.05）;Lesion distribution location, edge, aggressive,it was also a significant differences. Conclusion observing parotid gland tumor lesions in different periods enhanced scanning strengthening characteristics by spiral CT and the combination of different parts of the lesion, shape, edge, aggressive, etc., further can improve the accuracy of qualitative di- agnosis of parotid gland tumors, and provide more scientific, objective basis for clinical reasonable treatment.