MSCT对腮腺良、恶性肿瘤鉴别诊断价值及影像学典型征象分析

Analysis of the Value of MSCT in the Differential Diagnosis of Benign and Malignant Tumors of the Parotid Gland and Their Typical Imaging Signs

目的探讨MSCT用于鉴别腮腺良、恶性肿瘤的诊断价值以及分析MSCT检查对于腮腺良、恶性肿瘤的影像学典型征象。方法选取本院2016年3月至2018年6月经过治疗的80例术后病理证实的腮腺肿瘤病患,收集患者临床及影像学资料,观察患者MSCT扫描的影像特点,与病理诊断结果进行比较。结果MSCT诊断腮腺肿瘤良、恶性的正确率为92.50%,其中诊断正确率最高的为多形性腺瘤,其次是腺淋巴瘤,对腺样囊腺癌的诊断正确率最低,而MSCT对腮腺良性肿瘤的诊断正确率更高。黏液表皮样癌:边界不清、轮廓不规则肿块;进行增强后可见不均匀轻度、中度的强化,与周围脂肪的间隙消失。腺样囊腺癌:可侵犯深、浅两叶,相邻的动脉可被包裹、破坏,可侵犯皮下组织,周围淋巴结肿大。多形性腺瘤:可见边界连续、界限分明的圆形或椭圆形软组织肿块,增强扫描后可见肿块均匀或环形强化。腺淋巴瘤:稍高密度圆形肿块,常呈囊实性,处于腮腺的后下极;增强后实性组织及包膜轻中度强化,囊性部分不强化。结论MSCT对腮腺良、恶性肿瘤的诊断和鉴别诊断具有非常重要的意义,临床上可对MSCT征象进行全面分析,结合患者表现出的临床特征对腮腺肿瘤进行定性诊断。

Objective To explore the value of MSCT in the differential diagnosis of benign and malignant tumors of the parotid gland and to analyze the typical imaging signs of them in MSCT.Methods 80 patients with tumors of the parotid gland confirmed by surgery and pathology in our hospital from March 2016 to June 2018 were enrolled in this study.The clinical and imaging data of the patients were collected.The imaging features of CT scan and enhanced scan were observed,and the results were compared with pathological diagnosis results.Results The accuracy of MSCT in the diagnosis of benign and malignant tumors of the parotid gland was 92.50%.Among them,the highest rate of accurate diagnosis was pleomorphic adenoma,followed by adenolymphoma,and the lowest rate of accurate diagnosis was adenoid cystadenocarcinoma.MSCT has a higher accuracy for benign tumors of the parotid gland.Mucoepidermoid carcinoma:MSCT images showed unclear edges and mass with irregular contours.The enhancement was uneven,showing mild and moderate enhancement,and the surrounding fat gap disappeared.Adenoid cystadenocarcinoma:growing across the two lobes,and adjacent arteries were embedded,destroyed.It also showed invasion toward the subcutaneous and major lymph nodes.Pleomorphic adenoma:Moreover,it showed round or oval masses of soft tissue with a clear boundary.Enhanced scanning showed uniform mass or ring-shaped enhancement.Adenolymphoma:A round lesion with slightly high-density,which was mostly cystic,located in the posterioinferior portion of the parotid gland.Conclusion MSCT is of great value in diagnosising and differential diagnosis of benign and malignant tumors of the parotid gland.The MSCT signs can be comprehensively analyzed in the clinic,and a qualitative diagnosis of tumors of the parotid gland in combination with the clinical features exhibited by the patient.