腮腺肿瘤的CT诊断价值

CT diagnosis and differential diagnosis of the tumors in parotid gland

目的提高对腮腺肿瘤的CT诊断及鉴别诊断水平。方法回顾性分析65例腮腺肿瘤的CT表现和病理结果。结果混合瘤37例,乳头状囊腺瘤15例,管状腺瘤1例,基底细胞腺瘤2例,嗜酸细胞腺瘤1例,淋巴上皮囊肿2例,脂肪瘤2例,癌5例。混合瘤平扫多数为低密度或等密度,增强后轻中度强化或明显强化,行多期增强扫描病例表现为渐进性的强化;乳头状囊腺瘤平扫呈略低密度或等密度,增强后强化较为显著,行多期增强扫描病例无渐进性强化;管状腺瘤平扫可见囊变区,增强后实性部分及囊壁明显强化;基底细胞腺瘤平扫呈等密度不易发现,增强后呈明显不均匀强化;嗜酸性细胞腺瘤平扫为稍高密度,周围脂肪间隙略模糊,增强后呈环形强化;淋巴上皮囊肿平扫成囊样低密度,增强后囊壁强化明显,较为均匀;脂肪瘤平扫呈典型的脂肪密度,增强后无明显强化;腮腺癌平扫呈等密度,增强后明显不均匀强化,3例颈部可见肿大淋巴结。良性肿瘤包膜一般较完整,与正常腮腺组织分界清,恶性肿瘤侵犯周围组织,并可有相应区域淋巴结肿大。结论 CT可清楚显示腮腺区肿瘤的存在及定位,一定程度上可鉴别良恶性肿瘤,增强扫描有助于鉴别诊断。

Objective To improve the diagnosis and differential diagnosis rate of the masses in parotid gland region.Methods The CT findings of 65 tumors of the parotid gland were retrospectively analyzed.Results 37 cases were mixed tumor,15 cases were Warthin’s tumor,1 case was canalicular adenoma,2 cases were 2 Basal Cell Adenoma,1 case was Oxyphilic adenoma,2 cases were lymphoepithelial cyst,2 cases were lipoma and 5 cases were cancer.The mixed tumor was low density or isointensity in plain scan and slight to moderate enhancemented,while the cases with multi-phase enhancement showed progressive enhancement;The Warthin’s tumor showed hypodensity in plain scan and obvious enhancement,while the cases with multi-phase enhancement showed no progressive enhancement;The canalicular adenoma displayed cystic degeneration and obviously enhanced in parenchymal areas and the wall;The basal Cell Adenoma was isodensity with muscle or parotid gland in plain which was hart to detect and significantly and inhomogeneously enhanced;The Oxyphilic adenoma showed slightly high density before enhancement with blurred interface and was ring enhanced;The lymphoepithelial cyst showed cystic low-density when plain examination whose wall was obviously homogenously enhanced.The lipoma demonstrated typical fat-density with no enhancement;The parotid carcinoma showed isodensity in plain images and obviously inhomogeneous enhancement with cervical lymph node swelling in 3 cases.The envelope of benign neoplasm was complete and the boundary was clear.While the malignant tumor invaded surrounding tissue and the lymph node could be tumescence.Conclusion The masses could be displayed clearly and accurately located on CT.It also could be distinguish the benign and the malignant mass.Contrast enhancement could help differential diagnosis.