腮腺区先天性囊性占位性病变的影像诊断分析

Image Diagnostic Analysis of the Congenital Cystic Occupied Lesions in Parotid Region

目的探讨腮腺区先天性囊性占位性病变的超声、CT及MRI表现,提高对其认识及诊断水平。方法回顾性分析经临床及病理证实的33例腮腺区先天性囊性占位性病变的超声、CT和MRI资料,包括腮腺区单纯囊肿5例,表皮样囊肿8例、鳃裂囊肿9例、淋巴管瘤3例、淋巴上皮囊肿8例。结果腮腺区先天性囊性占位性病变的超声、CT及MRI表现为多单发的腮腺内或腮腺旁囊性、界清、形态规则、无血供的肿块,但各自又有不同影像表现,其中单纯囊肿表现为无回声,表皮样囊肿和鳃裂囊肿囊壁可强化,表皮样囊肿一般位置表浅,较鳃裂囊肿小,鳃裂囊肿内可见典型分层征象;淋巴管瘤呈分叶状、可跨叶匍匐生长,边界欠清,CT可呈多房样改变,增强无强化;淋巴上皮囊肿回声/密度/信号较前几者高。结论超声、CT和MRI可以显示病变的位置、形态、大小、回声/密度/信号变化、与周围结构的关系,综合三种影像表现有助于提高对腮腺区先天性囊性占位性病变定性诊断。

Objective To explore characteristics of the congenital cystic occupied lesions in parotid region found with the Ultrasound, CT and MRI, and to improve the knowledge and diagnostic skill about them. Methods Methods Images findings of the Ultrasound, CT and MRI of the congenital cystic occupied lesions in parotid region of 33 cases proven on histological examination were reviewed retrospectively. Simple cyst in 5 cases, epidermoid cyst in 8 cases, branchial cyst in 9 cases, lymphangioma in 3 cases, and lymphoepithelial cyst in 8 cases were included. Results Most lesions were found as solitary, cystic and well-defined masses in parotid region in images of the Ultrasound, CT and MRI. Epidermoid cyst, branchial cyst, simple cyst and lymphoepithelial cyst showed regular shape, no blood supply and non-enhancing mass. But there were some suggestive imaging findings. Simple cyst presented with no echo. Capsule walls of the epidermoid cyst and branchial cyst were enhanced after contrast administration. Eepidermoid cyst were always superficial, and smaller than branchial cyst. Interface signs from different echo or intense signals are very suggestive of a branchial cyst. The echo/density/signal of the lymphoepithelial cyst were higher than that of the epidermoid cyst and branchial cyst. The lymphoepithelial cyst was found as polycystic-like in the CT. Lymphangioma showed as lobulated, creep growth, ill-defined and non-enhanced mass. Conclusion The location, shape, size, echo/density/signal variation and the structure around about the lesion can be found in images of the Ultrasound, CT and MRI, and diagnosis of the congenital occupied lesions in parotid region could be improved combine with the imaging characteristics.