60例腮腺肿块CT特征的诊断意义

Significance of CT Findings in the Diagnosis of Parotidean Phyma

目的:用CT扫描获得不同类型腮腺肿块的鉴别诊断。材料与方法:60例腮腺肿块患者,其中良性肿瘤23例,恶性肿瘤29例,炎性病变8例。用CT进行扫描,结果:肿块的CT特征为:良性肿瘤表现为边缘清楚、锐利,并有1/3的病例伴有肿块内圆形液化;恶性肿瘤表现为1/3的病例边缘模糊、有树枝状突起、基突显著移位,肿块内不规则液化,钙化呈砂粒状,肿瘤较大时侵及邻近肌肉,增强扫描时密度低于正常肌肉等;炎性肿块表现为3/4以上的病例边缘树根状突起,未见边缘清楚、基突显著移位等特征,肿块圆形液化仅占1/8,钙化为块条状,占2/8,侵及肌肉时增强扫描密度高于正常肌肉。结论:腮腺肿块CT检查平扫与增强扫描并结合腮腺导管造影CT,诊断符合率可达97％,被认为目前腮腺检查的最好手段。

Purpose: To Obtain the differential diagnoses of various types parotidean phyma from CT. Materials and Methods: CT Scanning in 60 cases of patients with parotidean phyma in which include 23 cases of benign tumors , 29 cases of malignat tumors, and 8 cases of inflammatory phyma have been performed. Results: For benign tumors. CT features are to have clear and sharp edge, in addition, nearly one third of cases accompanied with intra - phyma rounded liquefaction. For malignant tumors, more or less accompanied with dendritic Process in the edge of phyma, obvious translocation of style, irregulary liquefaction and Psammoma calcification in the centre of phyma, and enhancing scanning density in invaded muscles was lower than that of normal muscles. For inflammatory phyma, their CT features appear partly as the edge to be unclear, simultaneously, three fourth of cases had dendritic processes, but style’s translocation like malignant tumors can’t be found, enhancing scanning density in invaded muscles was higher than that of normal muscles. Conclusion: Analyses of 60 cases of patients showed that the rate conformable to diagnoses can achieve to 97 percent when general scanning and enhancing scanning were combined with CT of ductus parotidean during the examination. For the differential diagnoses of various parotidean phyma, CT is a more satisfactory method.