涎腺良恶性病变的CT鉴别诊断

目的探讨CT对涎腺良恶性病变鉴别诊断的价值。方法回顾性分析经手术病理证实(个别经穿刺细胞学证实)的涎腺良恶性病变36例,其中良性肿瘤19例,慢性炎症5例,结核1例,恶性肿瘤11例,从形态、密度、边缘、皮肤是否受累及颈淋巴结有无肿大等方面分析其CT表现。结果良性肿瘤大多形态规则(17/19),边缘清晰锐利(16/19),与周围组织分界清楚,慢性炎症轮廓较规则,但边缘模糊,增强扫描强化程度不一。恶性肿瘤CT多表现为形态不规则(7/11),边缘模糊,与周围组织分界不清,相邻的脂肪间隙模糊、消失,皮下脂肪层受侵,表皮线样影消失。部分病例(3/11)表现为涎腺弥漫性增大而形成“铸型”。大多数良性病变和恶性肿瘤的密度均表现为密度不均匀甚至是大范围的囊变、坏死。结论CT对涎腺良恶性病变的鉴别诊断具有很高的价值。

CT Differential Diagnosis of Salivary Lesions

Objective To study CT diagnostic value of benign and malignant salivary gland lesions.Methods CT features in 36 cases with pathologically-proved salivary lesions were retrospectively analyzed.There were 19 cases with benign tumors,5 cases with chronic inflammation,1 case with tuberculosis and 11 cases with malignant tumors.Results Benign tumors were regular in 17 and well-defined in 16.All cases with chronic inflammation and 1 case with tuberculosis were regular but ill-defined.Benign lesions showed homogeneous or inhomogeneous density.Of all 11 malignant tumors,7 cases presented ill-defined margin with irregularity in shape,infiltration of adjacent subcutaneous fat tissue and disappearing of epiderm.Salivary glands enlarged and looked like "cast form" in malignant tumors.Most of the malignant tumors and benign tumors presented inhomogeneous density.Conclusion CT scan is of important value in the diagnosis of salivary diseases.