MSCT对腮腺多结节病变的诊断价值

The value of MSCT diagnosis of multiple nodules lesion of parotid gland

目的应用MSCT探讨腮腺多发结节状病变的特征及临床应用价值。方法回顾性分析43例经手术病理证实腮腺多发结节的CT表现,所有病例均行平扫和增强扫描。结果 43例中,位于双侧21例(49%)、单侧22例(51%);腺淋巴瘤最常见,占24例(55%),多发生于双侧(15/24),病灶囊变坏死少见(5/24);多形性腺瘤8例(18%),单侧多见(6/8);慢性腮腺炎3例,结节较小,直径0.2～1.5cm,边缘欠清晰;结核性肉芽肿2例、病灶呈环形强化,中心密度低;嗜酸性粒细胞增多性血管淋巴样增生1例,影像表现无特异性;腮腺多发结节恶性肿瘤少见(5/43),为继发性,其中恶性淋巴瘤3例、转移瘤2例,皆有颈部淋巴结肿大或原发灶病史。结论腮腺多发结节状病变的MSCT表现具有一定的特征性,对病变的定性诊断及鉴别诊断有重要价值。

Objective To explore the characterization of multiple nodules lesion of parotid gland and clinical application value. Methods The CT findings of 43 cases with multiple nodules about parotid gland confirmed by operation and pathology were analyzed retrospectively, all of them were examined by plain CT scan and enhanced scan. Results In 43 cases, 21 were bilateral (49%), and 22 were unilateral (51%). Among them,adenolymphoma was the most common, accunting for 24 cases (55%), and occurring more often in the bilateral parotid gland (15/24) and the area of cystoid variation and necrosis were rarely seen (5/24). The pleomorphic adenoma had 8 cases (18%), more common in one side (6/8). 3 cases were chronic parotitis with short length of small nodules lesion diameter about 2 to 10 millimeter and unclear border. 2 cases were tuberculous gumma with ring potentialization and lower central density after enhancement. 1 case was angiolymphoid hyperplasia with eosinophilia which had no characteristic features. It's uncommon of malignant tumor with multiple nodules about parotid gland including 3 cases of malignant lymphoma and 2 cases of metastases. These secondary lesions all had lymphadenopathy or clinical history and primary tumor. Conclusion MSCT appearance in multiple nodule lesion of parotid gland has certain characteristics and has important clinical significance for diagnosis and differential diagnosis.