腮腺多形性腺瘤与沃辛瘤的CT特征

CT features of parotid pleomorphic adenoma and Warthin tumor

目的:探讨计算机体层成像(computed tomography,CT)对腮腺多形性腺瘤(pleomorphic adenoma,PA)与沃辛瘤(Warthin tumor,WT)的诊断与鉴别诊断价值。方法:回顾并分析经病理学检查确诊的25例PA与20例WT的临床及影像学资料。患者均行颌面部CT平扫及增强扫描。结果:25例PA患者中,男性9例(36.0%),女性16例(64.0%),平均年龄(44.1±13.6)岁,均为单发,病灶位于非后下象限者22个(88.0%),增强均表现为渐进性强化,静脉期呈轻-中度强化。20例WT患者均为男性(100.0%),平均年龄(58.0±9.2)岁,均有长期吸烟史;其中10例(50.0%)多发,共35个病灶,25个病灶(71.4%)位于腮腺后下象限,35个病灶(100.0%)动脉期呈中度或明显强化,静脉期强化程度减低,呈“快进快出”表现。结论:不同的临床及CT特征在腮腺WT与PA的鉴别诊断中具有较高价值,可以对绝大多数病灶作出明确诊断。

Objective:To explore the value of computed tomography(CT)in diagnosis and differential diagnosis of pleomorphic adenoma(PA)and Warthin tumor(WT).Methods:The clinical data and imaging manifestations of 25 cases of PA and 20 cases of WT confirmed by pathology were analyzed retrospectively.All the patients underwent maxillofacial CT unenhanced and dynamic enhanced scans.Results:All 25 cases of PA,including 9 males(36.0%)and 16 females(64.0%),with an average age of(44.1±13.6)years,were solitary lesions,in which 22 lesions(88.0%)were located in the non-posterior inferior quadrant.On enhanced CT,all lesions showed progressive enhancement and mild to moderate enhancement in the venous phase.All 20 cases of WT were males(100.0%),with an average age of(58.0±9.2)years,and a long history of smoking.10 cases(50.0%)were multiple lesions.In total of 35 lesions,25 lesions(71.4%)were located in the posterior inferior quadrant;35 lesions(100.0%)showed moderate or obvious enhancement in the arterial phase,while the enhancement was decreased in the venous phase,which showed“quickly forward and quickly quit”.Conclusion:Different clinical and CT features have high value in the differential diagnosis of WT and PA,most of lesions can be diagnosed correctly.