腮腺肿瘤的多层螺旋CT表现

Multi-slice Spiral CT Manifestation of Parotid Tumors

目的探讨腮腺肿瘤的多层螺旋CT表现,为临床提供参考。方法回顾性分析23例经手术病理证实的腮腺肿瘤患者(粘液表皮样癌3例,多形性腺瘤11例,腺淋巴瘤4例,脂肪瘤2例,嗜酸性淋巴细胞肉芽肿2例,肌上皮良性病变1例)的多层螺旋CT表现,分析肿瘤的分布、形态、密度、边缘、囊变坏死、强化程度、颈部淋巴结肿大等情况。结果病变主要为腮腺单侧发病,其中左侧15例,右侧8例。良性肿瘤多位于腮腺浅叶或深浅叶交界,表现为类圆形或团块影,边界清晰,密度均匀且高于正常腮腺,增强扫描多呈均匀强化,其中钙化多见于多形性腺瘤,囊变多见于多形性腺瘤、腺淋巴瘤。恶性肿瘤多位于深叶,呈分叶状,边界欠清晰,密度不均匀且高于正常腮腺,增强扫描呈不均匀强化,常伴颈部淋巴结肿大。结论腮腺肿瘤具有一定影像学特点,多层螺旋CT有助于该病的诊断及鉴别诊断,具有重要的临床诊断价值。

Objective To investigate the multi-slice spiral CT（MSCT） features of parotid tumors to provide clinical references. Methods Retrospective analysis was conducted on the MSCT manifestation of 23 patients whose diagnosis of parotid tumors were confirmed surgically and pathologically（including 3 cases of mucoepidermoid carcinoma, 11 cases of pleomorphic adenoma, 4 cases of adenolymphoma, 2 cases of lipoma, 2 cases of eosinophilic lymphocytes in the granuloma, 1 case of benign myoepithelial tumor）. Through the CT manifestation tumor distribution, form, density, edge, cystic degeneration or necrosis, degree of enhancement, cervical lymph node enlargement of 23 cases were studied. ResultsMost pathological changes of the parotid gland were unilateral, of which 15 were left and 8 were right. Benign tumors usually located at the junction of the superficial lobe of parotid glands and the deep lobe of parotid glands. The shape of benign tumors was round or mass. The boundary was clear, and the density was uniform and higher than the normal parotid gland tissue. As shown by enhancing scanning, the calcification was found in the multiple adenomas and the cystic changes were found in the pleomorphic adenoma. Malignant tumors were usually located in deep lobes and were lobulated. The boundary was less clear. The density was uneven and more dense than normal parotid gland. Enhanced scan revealed inhomogeneous enhancement. Malignant parotid tumors were often accompanied by cervical lymph node enlargement. Conclusion Parotid gland tumors have certain imaging features. MSCT is helpful in the diagnosis and differential diagnosis and has important clinical diagnostic value.