超声在腮腺多形性腺瘤和Warthin’s瘤诊断中的价值

目的 :探讨超声对腮腺多形性腺瘤和Warthin’s瘤的诊断价值。方法 :回顾性分析经手术病理证实的56例腮腺多形性腺瘤和54例Warthin’s瘤的临床资料,及其二维、彩色多普勒及超声弹性声像图资料,并进行统计学处理。结果:多形性腺瘤和Warthin’s瘤的性别、年龄、发病数目、发病象限、横纵径比值、形态、内部回声、特征性无回声、0级和Ⅲ级血流信号出现率、弹性评分分值等方面差异均有统计学意义(P<0.05);在发病部位、最大径、最小径、边界、内部强回声等方面差异均无统计学意义(P>0.05)。结论:腮腺多形性腺瘤和Warthin’s瘤的超声声像图有一定特征,结合临床病史可帮助对二者的鉴别诊断。     

超声检查在多形性腺瘤和Warthin瘤鉴别诊断中的应用

目的:回顾性分析腮腺多形性腺瘤与Warthin瘤的超声声像图,总结其声像图特征,为两者的鉴别提供参考。方法:回顾经病理确诊的24例腮腺多形性腺瘤及18例Warthin瘤患者的超声检查结果,分析其声像图表现特征。结果:大多数多形性腺瘤为低回声,回声均匀一致,或呈小分叶状,后方回声增强,周边型血流。而Warthin瘤多呈椭圆形,内部常伴有囊性成分,为内在型血流。结论:腮腺多形性腺瘤与Warthin瘤在声像图上有些相似,容易误诊。超声检查在两者的鉴别诊断中有较高的临床价值,可为临床的治疗及手术方案提供鉴别依据。     

超声在腮腺Warthin's瘤和基底细胞腺瘤鉴别诊断中的价值

目的:分析腮腺Warthin’s瘤和基底细胞腺瘤的临床资料及超声声像图特征,为术前两者的鉴别诊断提供依据。方法:回顾性分析经病理证实的52例腮腺Warthin’s瘤和27例基底细胞腺瘤(BCA),比较两组患者的发病年龄、性别、病程、发病部位,肿瘤的最大径、形态、边界,其超声检查结果内部回声、有无包膜、后方回声是否增强及血流分布情况。结果:Warthin’s瘤多发生于中老年男性,而基底细胞腺瘤患者年龄通常较Warthin’s瘤为轻,且女性多见(P<0.05)。大多数Warthin’s瘤肿瘤最大径较基底细胞腺瘤大,网格样回声常见,有较丰富血流信号。而基底细胞腺瘤常为均匀一致的实质性肿块,常见液化,有完整包膜,肿块后方回声增强,无或有少许血流信号。结论:根据患者年龄、性别等临床资料结合超声声像图特征性表现,可于术前有效鉴别腮腺Warthin’s瘤和基底细胞腺瘤,为手术方案的选择及进一步的临床治疗提供依据。     

涎腺Warthin瘤超声特征与病理对照分析

目的 总结涎腺Warthin瘤的超声图像表现,旨在提高超声诊断的准确性。方法 回顾性分析58例（69个病灶）涎腺Warthin瘤的超声图像表现,并与病理检查结果进行对照分析。结果 涎腺Warthin瘤的超声表现分为3种类型。Ⅰ型：实性肿块型（34个,49.3%）,超声表现为实性弱回声团块,内部见部分网格状回声;病理显示为多种组织成分（如腺上皮细胞、淋巴组织、纤维组织）排列致密而均匀,上皮形成乳头状结构突入少量黏液构成的小囊腔。Ⅱ型：囊实性肿块型（30个,43.5%）,团块内可见片状无回声,囊实性分界清楚;病理显示腺上皮细胞构成不规则的腺管和囊腔样结构,囊腔内含有较多淡黄色黏液或棕色胶冻样物。Ⅲ型：囊性肿块型（5个,7.2%）,超声显示肿块呈分隔状囊性团块;病理显示Warthin伴梗死及感染。超声与病理诊断的符合率为79.7%。结论 Warthin瘤的超声图像表现基于病理组织结构,掌握Warthin瘤的不同超声图像特征以及病理改变有助于作出较为准确的超声诊断。     

局灶性腮腺病变三维超声成像的初步研究

目的探讨三维超声成像（3DUS）在局灶性腮腺病变的诊断与鉴别诊断中的应用价值。方法对33例局灶性腮腺病变行三维超声检查,评价其立体形态、体积、与周围结构毗邻关系等信息,并初步判断病灶良恶性;诊断结果与术后病理结果进行比较,计算敏感性、特异性、阳性预测值、阴性预测值、准确性及Youden指数等统计学指标。结果三维超声可以较好地显示病灶的形态、边缘及与周边结构的关系,其对病灶良恶性的判断敏感性为85.7%、特异性为100%、阳性预测值为1.0、阴性预测值为0.96、准确性为96.97%、Youden指数为0.857。结论3DUS在局灶性腮腺病变的诊断与鉴别诊断方面具有一定的应用价值。     

腮腺脂肪瘤的CT与MRI影像学表现

目的:探讨腮腺脂肪瘤的CT与MRI表现特点,并与病理结果对照,以提高对该病的认识.方法:回顾性分析经手术病理证实的16例腮腺脂肪瘤患者的CT与MRI资料(CT检查12例,MRI检查10例,其中有6例分别行CT、MRI检查).对肿瘤的部位、大小、形态、边界、内部密度(信号)、增强特点及病灶周围有无肿大淋巴结等进行分析,并...     

腮腺区包块诊断分析

目的:提高对腮腺区包块的诊断水平。方法:收集5年间296例腮腺区包块的临床资料,对其一般情况、疾病构成、临床表现、诊断方法等进行分析。结果:男、女之比约1.19∶1,年龄最小1岁,最大83岁;多形性腺瘤80例,占腮腺区包块的27%,占腮腺区良性肿瘤的50%;Warthin瘤50例,占腮腺区包块的16.9%,占腮腺区良性肿瘤的31.3%;炎性包块27例,占腮腺区包块的9.1%。黏液表皮样癌14例,占腮腺区包块的4.7%,占腮腺区恶性肿瘤的29.2%;腺样囊性癌7例,癌在多形性腺瘤中7例,均占腮腺区包块的2.4%、腮腺区恶性肿瘤的14.6%;鳃裂囊肿6例,占腮腺区包块的2.0%;多形性腺瘤以40～49岁年龄组及50～59岁年龄组最多见(χ2检验,P<0.005),Warthin瘤以50～59岁年龄组、60～69岁年龄组、70～79岁年龄组最多见,且40岁以前其发病率为0(χ2检验,P<0.005);炎性包块可见于任一年龄组,且以60～69岁年龄组最多见(χ2检验,P<0.005)。结论:腮腺区包块涵盖的疾病复杂,表现多样,应结合其临床表现、B超、CT、MRI等影像学检查、细针吸细胞学检查、术中快速冰冻病理检查等综合考虑选择合适的治疗或手术方案。     

腮腺造影螺旋CT检查在腮腺肿物诊断中的应用

回顾分析51例腮腺肿物患者应用腮腺造影螺旋CT检查并重建,结果与病理比对,总结影像特点。其中,结合肿瘤的形态特点和位置特征,对15例多形性腺瘤和15例腺淋巴瘤术前正确诊断;4例恶性肿瘤(恶性多形性腺瘤1例,腮腺鳞癌1例,黏液表皮样癌1例,腺样囊性癌1例)术前提出恶性诊断,另外4例误诊为良性肿瘤;有2例腮腺区淋巴结误诊为腮腺肿瘤经手术治疗。该方法完成的腮腺肿瘤检查图像显示腮腺肿瘤及导管系统清楚,与周围组织关系判断直观,腺淋巴瘤、多形性腺瘤和典型的恶性肿瘤有一定的影像特征,是一项较为实用的检查手段。     

105例腮腺肿块的临床病理与超声影像的相关性研究

目的：探讨腮腺肿块临床病理与超声影像之间的关系,为腮腺良恶性肿块的临床鉴别诊断及治疗决策提供参考。方法：对105例经手术、病理证实的腮腺肿块的临床病理资料和超声检查资料进行回顾性研究。结果：105例腮腺肿块中,病理类型良性92例,恶性13例。良恶性肿块在形态、边界、包膜等声像学表现阳性率间具有统计学差异（P〈0.05）;但在内部回声分布、后方回声增强方面无明显统计学差异（P〉0.05）。结论：腮腺肿块的不同临床病理类型与其超声表现有一定的关系,肿块的超声表现可为术前良恶性鉴别诊断及临床治疗决策提供参考。     

腮腺内面神经鞘瘤21例临床分析

目的　探讨腮腺内面神经鞘瘤的临床特点、诊断及治疗要点,最大程度保留面神经连续性。方法　回顾分析中国医科大学附属口腔医院2005~2011年收治的21例腮腺内面神经鞘瘤患者的临床特点、影像学表现、诊断及治疗。结果　21例患者中术前行影像学检查共18例,确诊为神经鞘瘤者仅1例。21例患者均行手术切除肿瘤并经病理明确诊断,其中18例患者瘤体完整切除,3例患者瘤体部分切除。共19例患者术后随访,随访期为1~5年,所有随访病例未发现肿瘤复发。结论　腮腺内面神经鞘瘤早期诊断较困难,影像学检查虽有辅助价值,但确诊仍有赖于病理诊断,该病以手术治疗为主,术中应尽量保护面神经,避免并发症的发生。     

腮腺沃辛瘤发病情况分析

本文总结２５年中诊治的１７６例腮腺沃辛瘤（Ｗａｒｔｈｉｎ瘤）的临床资料进行发病情况分析。腮腺沃辛瘤占同期所有腮腺上皮性肿瘤的１５．３％，良性肿瘤的２０．６％。将２５年平均分为５个研究周期，Ｗａｒｔｈｉｎ瘤在所有腮腺肿瘤以及良性肿瘤中的构成比均呈稳定上升趋势，９０年代初比７０年代初增长３倍。患者的性别差异无明显变化，女性患者的比例无明显上升，男女比例持续保持在６：１左右。发病年龄集中在５０～６９岁，６０岁以上有逐渐递增趋势     

Is ultrasound alone sufficient for imaging superficial lobe benign parotid tumours before surgery?

Ultrasound (US) is a valuable technique for the assessment of salivary gland disease and regional nodes. When used in combination with fine needle aspiration cytology (FNAC) or core biopsy it has a high sensitivity and specificity in the diagnosis of tumours. The role of additional cross-sectional imaging (computed tomography (CT) or magnetic resonance (MR)) to help with the diagnosis of benign parotid tumours is questionable except when there is deep lobe extension or the suggestion of malignancy. We investigated 37 FNAC-confirmed benign parotid tumours in patients who had undergone both US and CT or MRI investigations, to find out whether cross-sectional imaging had provided any further useful diagnostic information before operation. Three patients had bilateral Warthin tumours. Tumours ranged in size from 11 to 45 mm (mean 22). Of the 37 patients 35 (95%) had a clearly delineated mass in the superficial lobe of the parotid on US and no further information was gained from additional CT or MRI. On US 34 patients (92%) had features suggestive of a benign tumour, and three had features suggestive of malignancy but these were found to be benign on FNAC and after operation. CT or MRI confirmed these suspicious findings. In two different patients the deep margin was not visible on US (suggestive of deep lobe extension) and this was confirmed on MRI. The mean time delay between US and CT or MRI was four weeks (range 1-44). These results suggest that additional imaging is not required in most patients with a sonographically and FNAC confirmed benign lesion confined to the superficial lobe of the parotid and confirmed by FNAC or biopsy examination.     

Brucella melitensis infection within warthin tumor of the parotid gland

Brucellosis is a zoonotic systemic infectious disease, and multiorgan involvement is commonly seen, but involvement of the neck is a rare presentation of brucellosis. Granulomatous infections of the parotid gland are extremely rare. Warthin tumor is a well-known benign neoplasm of the salivary glands. In this report, we describe a Warthin tumor associated with Brucella melitensis in the same parotid gland.     

腮腺沃辛瘤62例临床观察

目的:总结腮腺沃辛瘤的临床特点。方法:回顾性分析62例腮腺沃辛瘤患者的资料,分别就年龄、性别、吸烟情况、病变特点及治疗方法予以分析总结。结果:腮腺沃辛瘤好发于老年男性,患者多有明显长期吸烟史,病变多发生于腮腺下极,手术宜采用瘤体及部分腺体切除。结论:该肿瘤特点显著,应正确诊断和治疗。     

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目的 研究Warthin瘤中微淋巴管密度(MLVD)与肿瘤上皮细胞中血管内皮生长因子C(VEGF-C)的相关性.方法 收集1999-2008年内蒙古医学院附属医院和内蒙古自治区医院病理科存档的Warthin瘤病例109例,同时选取多形性腺瘤(PA)、正常涎腺、正常涎腺淋巴结各20例,采用免疫组化法检测各组织标本中VEGF-C和淋巴管内皮透明质酸受体-1(LYVE-1)的表达情况,并通过LYVE-1的表达来计数MLVD.结果 (1)Warthin瘤中MLVD明显高于PA、正常涎腺及其淋巴结（均P＜0.01）;(2)VEGF-C在Warthin瘤组织中呈强阳性表达,而在PA、正常涎腺组织及其淋巴结中呈弱阳性或阴性表达;(3)Warthin瘤中VEGF-C表达强度与MLVD呈正相关关系.结论 VEGF-C可介导Warthin瘤淋巴管生成.     

Parotid gland tumors in a Korean population

Salivary gland tumors occur in about 3% of the head and neck tumors, and among the salivary gland tumors, parotid gland tumor occurs in about 80%. Because of its low frequency and small cases, it is hard to establish the epidemiologic characteristics of the tumors. This study was performed retrospectively from February 1987 to August 2010. There were 95 male, and 76 female patients. Most of the patients complained of the painless and progressively enlarged mass in the preauricular area. Peak incidence of benign parotid gland tumor was at the fifth decade of life. In the malignant tumors, peak age in males was the eighth decade, and peak age in females was from the third to the fifth decade of life, which was relatively younger and has a broad range of spectrum. Pleomorphic adenoma was the most common benign tumor of the 93 cases (61.6%) followed by Warthin tumor, occurring in 20 cases (13.2%). Squamous cell carcinoma, reported in 6 cases (30%), is the most frequent. Mucoepidermoid carcinoma was the second leading tumor. In conclusion, parotid gland tumor incidence was found to be higher in males. Pleomorphic adenoma was the most commonly encountered type of parotid gland neoplasms, which is in agreement with findings from all of the published literature from all over world. In contrast to most of the previous studies, squamous cell carcinoma was the most frequent malignant tumor found. Based on the data in this study, it has significant clinical respect and is helpful in the management of parotid gland tumors in Orientals.     

腮腺嗜酸细胞腺瘤合并Warthin瘤1例报告及文献复习

一侧腮腺区同时发生不同组织学类型的肿瘤极少见。本文报告1例发生在腮腺一侧瘤体内同时存在嗜酸细胞腺瘤与Warthin瘤2种不同成分的罕见病例,并结合相关文献复习,对其病因、临床特点、诊断及治疗进行讨论。     

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??Objective    To evaluate clinical characteristics??pathology and imaging manifestation of multiple primary tumors ??MPT?? in parotid gland??and to analyze the value of enhanced CT in the deagnosis of parotid MPT. Methods            Retrospectively analyze the medical histories of 22 patients with MPT among 285 patients with parotid gland tumors from 2013 to 2016. Results    Seventeen cases were Warthin′s tumor??accounting for 77.3% of MPT in parotid gland. The detection rate of CT was 83.3%??higher than B-ultrasonography. For unilateral MPT in parotid gland??the detection rate of CT was 2 times of B-ultrasonography. Conclusion    Warthin′s tumor is the most common type of MPT in parotid gland. Enhanced CT examination may help find MPT in parotid gland before the surgery??which helps to make surgery plan.