CT及MRI在腮腺腺泡细胞癌与多形性腺瘤鉴别诊断中的价值

Analyzing the Value of CT and MRI in the Differential Diagnosis of Parotid Gland Acinar Cell Carcinoma and Pleomorphic Adenoma

目的目的探讨腮腺腺泡细胞癌(ACC)的影像学特点及其与多形性腺瘤(PA)的CT及MRI鉴别诊断价值。方法回顾性分析17例腮腺ACC的CT及MRI表现,对比分析其与61例PA的CT及MRI表现的差异,并行统计学检验。结果与PA相比,ACC在年龄、包膜、微囊改变、周围侵犯、ADC值(841.2±113.6/1285.1±244.6,P=0.000)及TIC曲线类型(A型:0/29;B型:1/0,P=0.000)方面差异均具有统计学意义(P<0.05),而在位置、最大径、边界、形态、肿瘤密度/信号、强化、出血、钙化、囊变及淋巴结肿大方面差异无统计学意义(P>0.05)。C型TIC曲线及ADC值在二者鉴别的敏感性分别达75.0%、90.5%,特异性分别达96.7%、100.0%。结论 CT及MRI不仅有助于ACC与PA的鉴别诊断,而且在其术前分期及判断预后中同样具有较大价值。

Objective To analyze the values of CT and MRI in the differential diagnosis of parotid gland acinar cell carcinoma（ ACC） and pleomorphic adenoma（ PA）. Methods The CT and MRI findings of 17 patients with parotid gland ACC were analyzed retrospectively,and compared with those in 61 patients with PA. Results The age,capsule,microcapsule,peripheral invasion,ADC value and TIC curve type were significantly different between ACC and PA（ P〈0. 05）,while the tumor location,maximum diameter,border,shape,tumor density/signal intensity,enhancement,hemorrhage,calcification,cystic change and lymphadenopathy were not significantly different（ P〉0. 05）. The sensitivity and specificity of C-type TIC curve and ADC value for diagnosis of ACC were 75. 0%,90. 5% and 96. 7%,100. 0% respectively. Conclusion CT and MRI are not only useful for the differential diagnosis of ACC and PA,but also have great value in the pre-operative staging and predictive prognosis.