12例Warthin瘤样黏液表皮样癌影像学分析

Imaging findings in 12 cases of Warthin-like mucoepidermoid carcinoma

目的:总结Warthin瘤样黏液表皮样癌(Warthin-like mucoepidermoid carcinoma,WT-MEC)的超声、CT和MRI表现,探讨其影像学特点,为临床术前诊断提供参考。方法:收集2017年1月—2021年12月上海交通大学医学院附属第九人民医院收治的12例经病理明确诊断的WT-MEC患者的临床信息和超声、CT、MRI资料,回顾性总结其具体特征。结果:12例WT-MEC患者中,男7例,女5例,平均年龄为(42.7±16)岁。7例行超声检查,6例行CT检查,2例行MRI检查。所有肿瘤均表现为腮腺内单发肿块。91.7%(11/12)的病灶(91.7%)边界清晰,83.3%(10/12)的病灶呈囊实性肿块。在超声上,71.4%(5/7)的病变表现为囊实性混合回声、85.7%(6/7)血流不丰富、85.7%(6/7)后方回声增强。在CT上,所有病变(6/6,100%)呈软组织密度肿块,不均匀强化(5/6,83.3%)。在MRI上,肿瘤在平扫T1WI呈低信号或等信号,T2WI呈高信号,增强T1WI呈不均匀强化。结论:WT-MEC多表现为单发、边界清晰、无钙化的囊实性肿块。肿瘤内多发、大小不等的囊性部分是其影像学特征。

PURPOSE:To summarize the ultrasound,CT and MRI manifestations of Warthin-like mucoepidermoid carcinoma(WT-MEC),and to explore its imaging characteristics,so as to provide reference for clinical and preoperative diagnosis.METHODS:The clinical information and imaging data of ultrasound,CT and MRI of 12 patients with WT-MEC diagnosed by pathology in Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2017 to December 2021 were collected,and their specific characteristics were retrospectively summarized.RESULTS:Among the 12 WT-MEC patients,there were 7 males and 5 females,with an average age of(42.7±16)years.Seven cases underwent ultrasound examination,6 cases underwent CT examination,and 2 cases underwent MRI examination.Radiologically,all the lesions presented as a solitary mass.11/12 lesions(91.7%)were identified as well-defined margins,and 10/12(83.3%)as solid-cystic masses.All solid-cystic lesions contained multiple cystic areas with variable sizes.On US images,most lesions showed mixed-echoic echogenicity(5/7,71.4%),poor vascularization(6/7,85.7%)and acoustic enhancement(6/7,85.7%).CT revealed all the lesions(6/6,100%)as a soft-tissue mass with heterogeneous enhancement(5/6,83.3%).MRI imaging demonstrated the neoplasm with low or iso-signal intensity on plain T1WI and hyperintensity on T2WI.The heterogeneous enhancement was shown on contrast-enhanced T1WI.CONCLUSIONS:Most WT-MECs represent as a solitary,well-defined,solid-cystic mass in the parotid gland.The neoplasm may be characterized by the multiple and variable-sized cystic components within the tumor.