腮腺结核的CT特征

CT characteristics of tuberculosis in parotid gland

目的观察腮腺结核的CT影像特征。方法回顾性分析经手术病理证实的16例腮腺结核,术前均行CT平扫和增强扫描。结果 113例累及腮腺淋巴结,2例同时累及腮腺淋巴结和实质,共检出35个淋巴结结核,另1例为弥漫性累及腮腺实质。213例为单侧,3例为双侧。39例淋巴结型累及浅叶,7例同时累及浅叶和深叶。413例病灶密度均匀,3例病灶密度不均匀;增强扫描13例淋巴结型中,均匀强化2例、环形强化11例,1例整个腮腺实质弥漫性强化,2例大部分腮腺实质弥漫性强化并合并淋巴结环形强化。512例腮腺周围皮肤增厚,其中3例病灶与皮肤穿通形成窦道。13例只有同侧颈部淋巴结肿大,3例肺结核患者表现为双侧颈动脉鞘周围淋巴结肿大。结论腮腺结核的CT表现多样、无明显特征性,正确认识腮腺结核CT表现有助于腮腺结核与其他疾病的鉴别诊断。

Objective To observe the CT characteristics of tuberculosis in parotid gland. Methods Sixteen patients with tuberculosis in parotid gland confirmed by surgical pathology were analyzed retrospectively. All patients underwent preop- erative CT plain scan and enhanced scan. Results （1）There were 13 cases of lymph nodal tuberculosis and 2 cases of mixed tuberculosis in parotid gland, and then a total of 35 lesions were found in them, the other case was parenchymal tubercul6- sis and involved the whole parotid glands. （2）There were 13 cases involved unbilateral and 3 cases involved bilateral. （3）Nine cases involved the superficial lobe of parotid gland, seven cases involved both the superficial and deep lobes. （4）On no enhanced CT scan, 13 cases showed homogeneous density, and 3 cases were inhomogeneous density. On enhanced CT scan, moderate homogeneous enhancement were seen in 2 cases and ring enhancement were in 11 cases, diffuse enhancement was seen in the one case of parenchymal type, the two mixed type showed diffuse enhancement of parotid gland and ring en- hancement of lymph node. （~）Thickening of skin around the parotid gland were found in 12 cases. There were sinus tract between the lesions and skin in three of 12 cases. Ipsilateral lmphadenectasis were found in anterior and posterior triangles of the neck and submaxillary regions in 13 patients, bilateral lmphadenectasis were seen in 3 patients with pulmonary tuber- culousis. Conclusion CT characteristics of parotid tuberculosis is diversity and non-specific. Recognition and understand- ing the CT features of parotid tuberculosis is helpful for differential diagnosis.