原发性气管腺样囊性癌的多层螺旋CT诊断

Diagnosis of multi-detector spiral CT in primary adenoid cystic carcinoma

目的探讨原发性气管腺样囊性癌(ACC)的多层螺旋(MSCT)表现特征。方法回顾性分析我院经过手术及病理证实的13例原发性ACC的MSCT表现,并结合多种图像后处理技术进行分析诊断。结果13例气管腺样囊性癌,7例病灶位于气管上段,4例位于气管中段,2例位于气管下段;8例位于气管后壁及左侧壁,2例位于气管右侧壁;2例呈浸润性向腔内外生长,侵犯邻近组织结构。结论ACC的MSCT表现具有特征性,结合多平面重组技术,MSCT可准确反映ACC的大小、生长方式及邻近组织的侵犯。MSCT平扫薄层轴位图像能显示早期气管壁的细微改变,发现ACC早期无症状病灶。

Objective To investigate characteristics of MSCT of the primary adenoid cystic carcinoma.Methods The MSCT findings of 13 cases with primary adenoid cystic carcinoma of the trachea confirmed by surgery and pathology were retrospectivly analyzed in our hospital,the diagnosis and analyze were made by combining various image post-processing techniques.Results There were 13 patients with primary adenoid cystic carcinoma of the tra-chea.The location showed 7 cases in the upper part of the trachea,4 cases in the middle part of the trachea,and 2 cases in the lower part of the trachea.8 cases in the posterior and left side wall of the trachea,2 cases in the right side wall of the trachea,and 2 cases were infiltrating into and growing inside and outside the cavity,invasion of adjacent organizational structure.Conclusion Tracheal adenoid cystic carcinoma has certain MSCT characteristics.MSCT with MPR can display clearly tumor size,the growth pattern and some invasive characteristics of ACC including extra luminal extension and infiltrative wall thickening.MSCT with axial scan thin slice images can display subtle changes in the wall of the trachea at early stage,which early asymptomatic lesions will be found in ACC.