腮腺腺淋巴瘤的CT表现及临床病理特征分析

CT manifestations and clinicopathological features of parotid adenolymphoma

目的分析腮腺腺淋巴瘤的临床病理特征及CT表现,评价CT对该病的诊断价值。方法选取该院2010-01~2020-01经手术病理证实的腮腺腺淋巴瘤患者54例,均行CT增强扫描检查,分析其CT征象及病理表现。结果54例患者共发现76个病灶:其中单侧单发36例,单侧双发12例,双侧单发5例(10个病灶),双侧多发1例(6个病灶);边缘清晰63个,边缘模糊13个;74个病灶伴囊变区;病灶位于浅叶52个,深叶14个,跨叶10个;病灶上下径大于前后径及左右径60个;76个病灶均动脉期明显强化,静脉期强化程度减退;50个病灶增强后出现"贴边血管征",血管主要来自耳后动脉及颞浅动脉分支。结论腮腺腺淋巴瘤患者CT检查病变多呈类圆形,密度均匀,边界清楚,常伴有囊变,包膜完整,增强扫描呈动脉期明显强化,静脉期强化程度减退,病灶主要沿纵轴方向生长,结合"贴边血管征",可考虑腮腺腺淋巴瘤可能。

Objective To analyze the clinicopathological features and computed tomography(CT)manifestations of parotid adenolymphoma,and to evaluate the diagnostic value of CT in the disease.Methods A total of 54 patients with parotid adenolymphoma confirmed by surgery and pathology in our hospital from January 2010 to January 2020 were selected as the study subjects.All the patients underwent enhanced CT scanning,and their CT manifestations and pathological features were analyzed.Results A total of 76 lesions were found in the 54 patients,including unilateral single lesion in 36 cases,unilateral double lesions in 12 cases,bilateral single lesion in 5 cases(10 lesions),and bilateral multiple lesions in 1 case(6 lesions).The edges were clear in 63 lesions and fuzzy in 13 lesions.There were 74 lesions with cystic changes,52 lesions in the superficial lobe,14 in the deep lobe and 10 in the trans lobe.There were 60 lesions with upper-lower diameter being greater than anteroposterior diameter and left to right diameter.All of the 76 lesions were significantly enhanced in arterial phase,and the degree of enhancement in venous phase decreased.Fifty lesions showed"marginal vascular sign"after enhancement,and the vessels mainly came from the branches of posterior auricular artery and superficial temporal artery.Conclusion CT findings in patients with parotid adenolymphoma are mostly circularly shaped with uniform density and clear boundaries,accompanied by cystic changes with intact capsule.Enhanced scanning shows significant enhancement in arterial phase and decreased enhancement in venous phase.The lesions mainly grow along the longitudinal axis,and Warthin tumor could be considered as a possibility in combination with"marginal vascular sign".