腮腺恶性肿瘤临床与影像学分析

目的：探讨腮腺恶性肿瘤的临床及影像表现。方法回顾性分析经临床病理证实的50例腮腺恶性肿瘤的临床资料，并对其中有影像资料的18例患者（3例超声，3例CT，3例MRI，6例行CT及超声，2例行MRI及超声，1例行CT和MRI）肿瘤位置、形态、大小、边界、内部结构、强化或血流情况等特征进行分析。结果18例腮腺恶性肿瘤表现为腮腺区结节或肿块，无痛性肿块16例，疼痛2例。肿块类圆形或椭圆形13例，肿块为实性16例，囊实性2例。部分不规则，边界清楚10例、不清晰8例。肿块可跨深浅叶（8例），可位于浅叶（10例）。单发17例，1例淋巴瘤多发。肿块多强化明显或血流丰富（15例）。肿块大小范围较大。肿块多有分叶征（15例）。转移瘤多发、常囊变坏死、边界不清。恶性淋巴瘤常多发、均质、边界清。结论腮腺恶性肿瘤有一定影像特征，但同良性肿瘤特征有重叠；合并淋巴结转移、肿瘤分叶且边界不清或侵犯周围结构、明显强化且不均匀或伴明显坏死等对腮腺恶性肿瘤的诊断有重要价值。

Clinical and imaging analysis of malignant tumors of the parotid gland

Objective To evaluate the clinical and imaging features of malignant tumors of the parotid gland.Methods The clinical information of 50 patients with histologically confirmed malignant tumors of the parotid glands and the imaging studies in 18 of these patients（3 US,3 CT,3 MRI,6 CT and US,2 US and MRI,1 CT and MRI）were reviewed.The location,shape,size, border,internal architecture,blood flow and contrast enhancement of the 18 tumors were analyzed.Results The 18 tumors were painless（16）or painful（2）,solid（16）or complex（2）masses with round/oval（13）or irregular（5）shapes,well-defined（10）or ill-defined（8）borders,located in the superficial lobe（10）,or in both deep and superficial lobes（8）.17/18 tumors were solitary and 1 case of lymphoma was multicentric.The tumors were mainly multilobular with significant contrast enhancement or abundant blood flow （15/18）.The metastases were often multiple with necrosis and ill-defined borders.The one case of lymphoma presented as multiple heterogeneous well-defined masses.Conclusion The imaging features of malignant and benign parotid gland tumors overlap. Multilobularity with ill-defined borders,marked heterogeneous contrast enhancement,necrosis,invasion of surrounding structures, and lymph node metastasis can aid diagnosis of malignancy.