涎腺淋巴上皮癌的CT和MRI影像学特征分析

CT and MRI features of lymphoepithelial carcinoma of salivary gland

目的分析涎腺淋巴上皮癌(LEC)的CT、MRI及功能MRI影像学特征。方法回顾性收集2010年3月至2020年3月上海交通大学医学院附属第九人民医院初诊并经术后病理证实的75例涎腺LEC患者,分析患者术前CT及MRI影像学表现。通过常规CT、MRI图像获取病灶的位置、大小、形状、边界、密度/信号强度、强化程度等信息。通过DWI及动态对比增强MRI(DCE-MRI)分别获取病灶的ADC值及时间-信号强度曲线(TIC)类型。结果75例涎腺LEC中53例位于腮腺,56例为单发病灶,38例形态为类(椭)圆形,34例为不规则形。仅1例伴钙化,5例伴坏死。68例CT检查中,28例呈中度强化,30例呈明显强化。12例MRI检查中,11例T1WI呈等信号,12例T2WI均呈稍高信号,增强后,11例均匀强化,12例均呈明显强化。涎腺LEC的ADC值为(0.68±0.05)×10^(-3)mm2/s,12例动态增强TIC类型均为Ⅱ型(速升平台型)。结论涎腺LEC多为单发、质地较均匀、中等以上程度强化、ADC值较低,DCE-MRI为Ⅱ型TIC,形态学表现结合功能MRI特点有助于其术前准确的影像诊断和鉴别诊断。

Objective To analyze imaging features of lymphoepithelial carcinoma(LEC)of salivary gland through conventional CT,MRI and functional MRI.Methods From March 2010 to March 2020,a total of 75 patients with salivary gland LEC who were initially diagnosed and confirmed by postoperative pathology were retrospectively collected in the Ninth People′s Hospital Affiliated to Shanghai Jiaotong University Medical College.The preoperative CT and MRI findings were analyzed.Information including location,size,shape,boundary,density/signal intensity and enhancement degree of lesions were evaluated by conventional CT and MRI.The ADC value and time-intensity curve(TIC)pattern of lesions were measured from DWI and dynamic contrast enhanced(DCE)-MRI.Results Among 75 cases of LEC in salivary gland,56 cases had solitary lesions,38 cases were round/oval or irregular,34 cases were irregular morphology.Only 1 case exhibited calcification and 5 cases had necrotic regions.In 68 cases with CT images,28 cases showed moderate enhancement and 30 cases showed intense enhancement.In 12 cases with MRI,11 cases showed iso-intensity on T1WI and 12 cases showed slightly hyperintensity on T2WI.After contrast injection,11 cases showed homogeneous enhancement and all of the 12 cases showed intense enhancement.The ADC value of LEC in salivary gland was(0.68±0.05)×10⁻³mm2/s and the TIC type of all the 12 cases was typeⅡ(fast rising platform type).Conclusion The LEC of salivary gland is single,has homogeneous texture,moderate enhancement and low ADC value.DCE-MRI shows typeⅡTIC curve.Morphological features combined with functional MRI features are helpful for accurate preoperative imaging diagnosis and differential diagnosis.