腮腺Warthin瘤的磁共振成像表现及病理基础分析

Magnetic resonance imaging findings and pathological analysis of parotid Warthin tumor

目的探讨磁共振成像在腮腺Warthin瘤(腺淋巴瘤)诊断与鉴别诊断中的应用价值。方法对2008年6月~2016年10月我院行MRI检查且手术确诊的38例腮腺Warthin瘤患者,结合完整的临床和影像学资料,回顾性分析MRI上肿瘤的信号、强化特点、部位、大小、形态、境界、轮廓、边缘及与邻近结构的关系,并与术后病理结果对照。结果本组38位患者,其中男性37位,女性1位,单发者17例,占比约46%,多发者21例,占比约54%,38位患者共有病灶69枚,其中呈实性者51例,占比约74%,囊变者18例,占比约26%。平扫T1WI多呈等或稍低信号,T2WI依据其成分及是否囊变可以稍低、等或高信号。69枚病灶中,增强扫描呈快进快出者63例,占比约91%,快进慢出者6例,占比约9%。MRI对病灶的定位诊断率约97%,诊断符合率约81%。结论腮腺Warthin瘤行磁共振检查特别是多期增强扫描,信号表现上有一定特异性,对腮腺肿块的鉴别诊断有重要意义。

Objective To explore the application value of magnetic resonance imaging in the diagnosis and differential diagnosis of parotid Warthin tumor（ gland lymphoma）. Methods From Jun. 2008 to Oct. 2016,38 patients with parotid Warthin tumor,who underwent MRI test and were confirmed by surgery in our hospital,with complete clinical and imaging data,were collected in this work. The tumor signal on MRI,strengthening characteristics,position,size,shape,boundary,edge contour,and the relationship with the adjacent structure were retrospectively analyzed and compared with postoperative pathologic results. Results Of those 38 patients,37 were male and 1 was female,in which single lesion was found in 17 cases,accounting for about46% and multiple lesions were found in 21 cases,accounting for about 54%. In the 38 patients,a total of 69 lesions were found,among which 51 were solid,accounting for about 74%,and 18 were cyst,accounting for about 26%. On plain scan,T1 WI showed iso-or lower signal,T2 WI displayed slightly lower,iso-or high signal,according to its composition and cyst. Among the 69 lesions,the enhancement scanning exhibited in fast forward and quickly out manner in 63 cases,accounting for about 91%,fast forward and slowly out manner in 6 cases,accounting for about 9%. The diagnostic rate for lesion localization by MRI was about97%,the coincidence rate of diagnosis was about 81%. Conclusion On MRI examination for parotid Warthin tumor,especially multiphase enhanced scanning,the signal performance has certain specificity,which has important significance for the differential diagnosis of parotid masses.