动态增强磁共振成像与弥散加权成像对腮腺肿瘤良恶性的鉴别诊断价值

目的 探讨动态增强磁共振成像(DCE-MRI)与弥散加权成像(DWI)对腮腺肿瘤良恶性的鉴别诊断价值。方法 选取103例腮腺肿瘤患者,均接受MRI检查,包括MRI平扫+DWI+动态增强扫描。以病理检查结果为金标准,比较良恶性腮腺肿瘤MRI影像特征、表观弥散系数(ADC)值、峰值时间(T_peak)、廓清率(WR),分析DWI、DCE-MRI单独及联合检查对腮腺肿瘤良恶性的鉴别诊断价值。结果 103例腮腺肿瘤患者中,良性74例,恶性29例,分别作为良性组和恶性组。良性组与恶性组腮腺肿瘤患者边界、形态、T2加权成像信号强度、信号均匀程度、周围组织侵犯情况比较,差异均有统计学意义(P﹤0.01)。多形性腺瘤组患者ADC值、Tpeak均高于腺淋巴瘤组和恶性组,WR₁₈₀、WR₃₆₀均低于腺淋巴瘤组和恶性组,且腺淋巴瘤组WR₁₈₀、WR₃₆₀均高于恶性组,差异均有统计学意义(P﹤0.05);但腺淋巴瘤组与恶性组患者ADC、T_peak值比较,差异均无统计学意义(P﹥0....     

磁共振弥散加权成像在肿瘤鉴别诊断中的应用

磁共振弥散加权成像（DWI）依靠不同组织间水分子弥散的差异性，提供一种与以往T1加权像、T2加权像不同的、新的成像对比。其在超早期脑缺血定位、定位诊断中的作用已被肯定，并已逐渐应用于其他系统疾病的诊断和鉴别诊断，其利用已引起人们广泛关注。现综述该技术的基本原理及在肿瘤鉴别诊断中的应用价值。     

磁共振弥散加权成像在乳腺良恶性病变鉴别中的应用价值

目的 探讨磁共振弥散加权成像（DWI）在鉴别乳腺良恶性病变中的应用价值.方法 对56例乳腺疾病患者采用3.0 T磁共振常规扫描、DWI,测量感兴趣区DWI的信号强度和表面扩散系数（ADC）值,并对得到的数据进行方差分析.结果 56例患者术后病理检查共检出122个病灶,其中乳腺癌病灶38个（31.15％）,包括浸润性导管癌32个,浸润性小叶癌2个,髓样癌4个;乳腺良性肿瘤病灶84个（68.85％）,包括纤维腺瘤55个,乳腺囊性增生病20个,乳管内乳头状瘤2个,乳管内乳头状瘤伴上皮中重度不典型增生3个,纤维脂肪瘤1个,乳腺炎症和出血3个.在ADC图上良性病灶呈相对高信号影;恶性病灶呈相对低信号影,与周围正常腺体组织分界清晰.正常乳腺腺体及良、恶性乳腺病灶在扩散敏感系数（b） =50s/mm2、b=800 s/mm2的信号强度值及ADC值比较,差异具有统计学意义（F=52.34、14.35、198.64,均P＜ 0.05）.两两比较结果显示正常乳腺腺体组与良性病变组在b=50 s/mm2、b=800 s/mm2的信号强度值及ADC值比较差异无统计学意义（均P＞0.05）,而其他各组之间两两比较差异均有统计学意义（t=23.65、12.65、13.85、24.10、5.65、6.98,均P＜0.05）.结论 DWI有助于乳腺良恶性病变的鉴别诊断,尤其ADC值是一个很有价值的参数.     

磁共振成像-弥散加权成像诊断良恶性卵巢肿瘤的临床价值

目的 探讨磁共振成像-弥散加权成像(MRI-DWI)诊断良恶性卵巢肿瘤的临床价值.方法 对经手术病理确诊为卵巢占位性病变的100例患者的MRI常规扫描参数及DWI图像表现进行分析.比较良恶性病变的病变最大径、表观扩散系数(ADC)值、肿瘤位置、边界、囊实性、囊壁/分隔、T1及T2信号均匀性,并进行Logis-tic回归...     

磁共振弥散加权成像在肿瘤鉴别诊断中的应用

磁共振弥散加权成像(DWI)依靠不同组织间水分子弥散的差异性，提供一种与以往T1加权像、T2加权像不同的、新的成像对比。其在超早期脑缺血定性、定位诊断中的作用已被肯定，并已逐渐应用于其他系统疾病的诊断和鉴别诊断，其作用已引起人们广泛关注。现综述该技术的基本原理及在肿瘤鉴别诊断中的应用价值。     

磁共振弥散加权成像诊断及鉴别脑脓肿与脑肿瘤坏死

目的:探讨磁共振弥散加权成像诊断及鉴别脑脓肿与脑肿瘤坏死。方法:回顾性分析2010年1月-2013年4月脑脓肿与脑肿瘤坏死患者,对在磁共振常规图像上表现液化的颅脑病变45例患者测量液化区域弥散系数值,观察影像学变化。结果:在磁共振弥散加权成像中,脑脓肿表现为明显的异常高信号影,脑肿瘤坏死则表现为明显低信号影,其中7例信号稍低。脑脓肿在脓肿或囊变坏死、对侧脑实质、脑脊液、脓液的液化区域弥散系数值分别为（0.32±0.12）、（1.11±0.23）、（0.43±0.12）、（0.42±0.12）,脑肿瘤坏死则分别为（2.43±0.89）、（1.32±0.54）、（0.67±0.15）、0,两者之间比较差异有统计学意义（P＜0.05）。结论:脑脓肿与脑肿瘤坏死在常规磁共振上鉴别困难,磁共振弥散加权成像则能明显鉴别。     

磁共振弥散加权成像在肿瘤放射治疗中的应用研究进展

成像生物标志物是测定和表征肿瘤以及监测治疗反应的重要工具.随着技术的快速发展,新的成像方法迅速呈现,其实用性需要系统评价.磁共振弥散加权成像（diffusion-weighted magnetic resonance imaging ,DW-MRI）通过表观弥散系数（Apparent diffusion coefficient,ADC）定量反映肿瘤内部水分子的微观运动-布朗运动（Brownian motion）.放射治疗是肿瘤治疗的主要手段之一,DW-MRI在肿瘤放射治疗方面包括靶区勾画、治疗反应监测和预后评价等显示出特有的应用价值.本文就DW-MRI在肿瘤放射治疗中的应用进行综述.     

磁共振扩散加权成像鉴别良恶性软组织肿瘤的价值

目的 :探讨磁共振扩散加权成像(DWI)鉴别良恶性软组织肿瘤的价值。 方法 :采用扩散加权成像分析43例软组织肿瘤,其中恶性25例,良性18例。所有病例均经手术病理证实。扩散加权成像的扩散敏感因子(b值)为0,500s/mm²。选取肿瘤实体部分最大感兴趣区,尽量避开坏死、出血、瘢痕及钙化等不均质成分。分析各病灶的扩散加权图像特点,比较良、恶性肿瘤表观扩散系数(apparent diffusion coefficient,ADC)的差异。3例恶性肿瘤患者化疗前、后进行DWI检查,分析ADC值的变化特点。 结果 :恶性肿瘤的ADC值(0.96±0.31×10^-3)mm²/s明显低于良性肿瘤的ADC值(1.92±0.63×10^-3)mm²/s和肌肉组织(1.69±0.47×10^-3)mm²/s的ADC值,差异具有统计学意义(P<0.05),良性肿瘤与肌肉的ADC值无明显差异。ADC值为(1.38×10^-3)mm²/s时,鉴别良恶性肿瘤的敏感性为92%,特异性为83%。3例恶性肿瘤患者化疗前、后进行DWI检查,其中2例化疗后ADC值升高,1例无ADC值的明显变化。 结论 :ADC值在软组织良恶性肿瘤的鉴别诊断中具有重要价值,ADC值对于化疗效果评价的作用需要进一步研究并与组织学对照加以证实。     

磁共振弥散加权成像诊断颈部淋巴结的临床价值

目的评价颈部淋巴结磁共振(MRI)弥散加权成像(DWI)的可行性,及其在良、恶性淋巴结鉴别诊断中的价值。方法对20例鼻咽癌患者和14例志愿者进行颈部常规MRI和DWI检查,比较两种检查方法对淋巴结的显示能力,并比较正常淋巴结与转移性淋巴结之间表观弥散系数(ADC)差异的统计学意义。扫描采用基于SENSE技术的STIR-EPI-DWI。结果弥散加权成像较常规MRI能更敏感性地显示淋巴结。正常淋巴结的ADC值为(0.975±0.179)×10~(-3)mm~2/s,转移性淋巴结的ADC值为(0.766±0.119)×10~(-3)mm~2/s,两者之间的差异有统计学意义(P<0.01),转移性淋巴结的ADC值明显低于正常淋巴结的ADC值。结论STIR-EPI-DWI能准确和更敏感地显示淋巴结,可作为淋巴结MRI成像的一种新手段,为良恶性淋巴结的鉴别诊断提供了新的方法。     

磁共振弥散加权成像在肺癌患者诊断中的应用研究

目的 探讨磁共振弥散加权成像(DWI)在肺癌患者诊断中的应用价值研究.方法 选取2016年5月至2019年8月间大连市第三人民医院收治的经病理检查确诊的89例肺癌患者,均行DWI检查,分析DWI在肺癌诊断中的应用价值.结果 随着b值升高,肺癌不同病理类型下表面弥散系数(ADC)值呈下降趋势,其中腺癌在不同b值下ADC值...     

Differentiation of malignant and benign lung lesions with diffusion-weighted MR imaging

Background

The aim of the study was to evaluate the role of diffusion-weighted magnetic resonance imaging in the differential diagnosis of lung lesions.

Patients and methods.

Sixty-seven patients with lung lesions (48 malignant, 19 benign) were included in this prospective study. Signal intensities (SIs) were measured in diffusion-weighted MR images that were obtained with b=0, 500 and 1000 s/mm² values. Apparent diffusion coefficient (ADC) maps were calculated by using images with b=0 and 1000 s/mm² values. The statistical significance was determined using the Student-t test.

Results

The SIs of malignant lesions were significantly higher than those of benign lesions (p<0.004 for b=0 s/mm² and p<0.000 for the other b values). Using b=500 s/mm², SI≥391 indicated a malignant lesion with a sensitivity of 95%, specificity of 73% and positive predictive value of 87%. Using b=1000 s/mm², SI≥277 indicated a malignant lesion with a sensitivity of 93%, specificity of 69% and positive predictive value of 85%. There was no significant difference between malignant and benign lesions regarding ADC values (p=0.675). There was no significant difference in SIs or ADC values between small cell carcinoma and non-small cell carcinoma. When comparing undifferentiated with well- partially differentiated cancers, SIs were higher with all b values, but the difference was statistically significant only with b=1000 s/mm² (p<0.04).

Conclusions

Diffusion-weighteted MR trace image SI is useful for the differentiation of malignant versus benign lung lesions.     

骨肿瘤的MR灌注和弥散加权成像研究

Objective:MR-PWI and MR-DWI were supplementary functional methods to differentiate benign from malignant bone tumors.The aim of this study was to assess the diagnostic potential of MR-PWI conjunction with MR-DWI in differentiating benign from malignant bone tumors.Methods:MR-PWI and MR-DWI were performed on 39 patients by using a 1.5 T MR imager.Perfusion imaging was started with GRE-EPI sequence as soon as che bolus administration commenced.With b value as 300 s/mm2,diffusion imaging was performed with SE-EPI sequence.mype of TIC,peak enhancement,steepest slope,signal difference between 2 baselines and ADC were compared between benign and malignant bone tumors.The data were analyzed with soft-ware(SPSS,version 13.0).Subjective overall pefrormance of two techniques was evaluated with Receiver Operating Characteristic(ROC)analysis.Resuits:1.MR-PWI:(1)The Patterns of TIC of most benign bone tumors(17/21)were type Ⅰ and Ⅱ,and all malignant bone tumors were type Ⅲ and Ⅳ.(2)There were significant differences in peak enhancemenl(17.52±2.37 vs.52.42±5.74)%,steepest slope(4.69±2.84 vs.9.63±4.05)%/S and signal difference between 2 baselines(6.87±3.34 vs.31.75±11.0g)% between benign and malignant groups.And their diagnosis accuracy was 82.1%,79.5% and 87.2%,respectively.(3).4 highly vascularized benign bone tumors were mistaken in diagnosis as malignant ones according to their perfusion characteristics.2.MR-DWI:There was significant difference between ADC of benign and malignant groups[(1.86±0.38)vs.(1.44±0.26)] ×10-3 mm2/s when b value was 300 s/mm2.The diagnosis accuracy was 79.5% when ADC value less than 1.63×10-3 mm2/s was considered as malignant ones.3.The diagnosis accuracy of MR-PWI and MR-DWI were 89.7% and 79.5%.respectively.Conclusion:MR-PWI is lhe better valuable technique than MR-DWI in differentiation benign from malignant bone tumors.To suspicious highly vascularized bone tumors.MR-PWI combining with MR-DWI lead to higher diagnosis accuracy.     

ICM-DNA定量检测在鉴别良恶性肿瘤诊断中应用

目的　探索ICM -DNA定量检测在鉴别良恶性肿瘤诊断中的应用。方法　对 12 1例原先不提供临床病史和病理检查结果的组织切片作改良的DNA染色和ICM -DNA定量检测。结果　 (1) 36例无ICM -DNA定量恶性指数的病例中 ,与原先临床及病理结果有 34例相吻合 ,其DNA指数 (DI) 0 .72 - 1.10 ,中位数DI 1.0 ,2倍体 (C)、3- 4C和≥ 5C细胞所占中位数百分比分别为 71.33%、2 6 .2 1%和 0 .98%。 (2 ) 85例有恶性指数与原先临床及病理结果完全一致 ,其DI自 1.2 - 2 .72 ,中位数DI 1.33,2C、3- 4C和 5C细胞所占的中位数百分比分别为 2 9.4 1%、6 2 .6 2 %和4 .76 %。 (3) 85例恶性组的DNA直方图表型为 :近二倍体肿瘤占 14.12 % (12 /85) ,近四倍体肿瘤占 2 .35% (2 /85) ,多倍体肿瘤占 5.88% (5/85)和非整倍体肿瘤 77.6 5% (6 6 /85)。近二倍体肿瘤多为黏膜相关淋巴瘤、高分化癌和低度恶性软组织肉瘤。结论　ICM -DNA定量分析中DI值、倍体分布、异倍体的比例和DNA直方图表型不仅是判别良恶性肿瘤的重要依据 ,而且正确运用内参和外参照校正ICM检测基准 ,合理的定标更是ICM -DNA定量鉴别良恶性肿瘤的关键。     

三种不同磁共振扩散加权成像模型在鉴别乳腺良恶性病灶中的价值研究

背景与目的：近年来扩散加权成像(diffusion-weighted imaging,DWI)技术的开展及应用,大大提高了磁共振（magnetic resonance,MR）的特异度,其中体素内不相干运动（intravoxel incoherent motion,IVIM）模型和扩散峰度成像（diffusion kurtosis imaging,DKI）模型作为新兴技术,已在临床研究中取得一定的进展。该研究探讨DWI的单指数模型、IVIM模型和DKI模型在乳腺良恶性病灶中的鉴别诊断价值。方法：该研究为前瞻性研究,纳入标准：超声或X线BI-RADS 4类及以上患者。排除标准：① 乳腺MR检查前已进行穿刺检查、新辅助化疗或手术的患者;② 图像运动伪影较重。所有患者术前均行双侧乳腺MR检查,扫描序列包括快速反转恢复（turbo inversion recovery magnitude,TIRM）、多b值DWI（RS-EPI）和T1W动态增强扫描。选取病灶实性成分最大层面且避开明显坏死、囊变液化区绘制感兴趣区（region of interest,ROI）,分别测量单指数模型参数表观弥散系数（apparent diffusion coefficient,D_ADC）值、IVIM模型参数[真实扩散系数（tissue diffusivity coefficient,D_DT）、灌注相关扩散系数（perfusion-related diffusivity coefficient,D^*）、灌注分数（perfusion fraction,f）]和DKI模型参数[峰度系数（kurtosis coefficient,K）、扩散系数（diffusivity coefficient,D_DK）]。采用独立样本t检验分别比较乳腺良恶性病灶组织上述参数的差异。采用受试者工作特征（receiver operating characteristic,ROC）曲线评价3种模型参数的诊断效能。采用Z检验比较各参数曲线下面积（area under curve,AUC）的差异。结果：依据上述标准共纳入80例患者（83个病灶）,其中良性病灶38个,恶性病灶45个。3种不同扩散模型中D_ADC值、D_DT值、K值及D_DK值在鉴别乳腺良恶性病灶中差异均有统计学意义（P均＜0.05）,其最佳阈值分别为D_ADC值1.08×10^-3 mm²/s、D_DT值1.06×10^-3 mm²/s、K值0.756及D_DK值1.36×10^-3 mm²/s。而D*值和f值在良恶性病灶之间存在较大重叠,差异无统计学意义（P＞0.05）。ROC曲线显示,K值和DDT值在鉴别乳腺良恶性病灶的AUC值最高,分别为0.956和0.947,K值的灵敏度和特异度为91.1%和89.5%,D_DT值的灵敏度和特异度为93.3%和84.2%;D_ADC值和D_DK值其次,AUC分别为0.933和0.923,DADC值的灵敏度和特异度为88.9%和84.2%,D_DK值的灵敏度和特异度为91.1%和84.2%。最后,D_ADC值、D_DT值、K值及D_DK值在鉴别乳腺良恶性病灶中的ROC曲线的AUC差异均无统计学意义（P均＞0.05）。结论：三种不同扩散加权成像模型在鉴别乳腺良恶性病灶中均有较好的诊断价值,其中IVIM和DKI的诊断效能较单指数模型略高,但 三者间差异无统计学意义。单指数模型扫描时间短,后处理简单,在临床应用价值很高。     

多层螺旋CT在腮腺良性肿瘤中的诊断价值(附84例分析)

Objective: The purpose of the study was to assess diagnostic performance of MSCT images in patients with parotid benign tumors and provide useful criteria for the characterization of their various pathological types preoperatively.Methods: Retrospectively analyzed clinical and imaging characteristics of 84 cases of pathologically confirmed primary parotid benign tumors.MSCT plain-scan and enhanced-scan were performed in all cases.After injection of 50 mL contrast material at a rate of 3.5 mL/s,spiral CT scans were obtained at arterial and venous phases with scanning delay of 30 s and 75 s,respectively.The attenuation change and enhancement patterns in the tumors were assessed.Quantitatively assess the increased CT number of the tumors in different enhanced-phases compared with the plain-scan and the ratio of increased CT number at venous phase scanning to that at arterial phase scanning also was calculated.Results: In all of 84 cases,40 cases were solitary pleomorphic adenomas,29 cases were adenolyphomas,6 cases were multiple tumors,2 cases were bilateral,15cases were Basal cell tumor,and one of them had two small lesions.The diameter was 1-5 cm in most of cases,whose margin was smooth and clear,cystic changes in some cases.At two-phase scans,pleomorphic adenomas showed a pattern of slight enhancement and venous enhancement,adenolymphomas showed a pattern of strong enhancement at arterial phase scanning with a decrease at venous phase scanning,basal cell tumor showed a pattern of persistent strong enhancement with commonly significant cystic areas.The ratio of increased CT number was significant different between adenolymphomas and other pathological types.Conclusion: The evaluation of enhancement patterns at two-phase enhanced-scan MSCT is helpful in the differential diagnosis of parotid gland benign tumors.     

磁共振成像对乳腺小肿块的鉴别诊断价值

目的探讨乳腺MRI鉴别乳腺小肿块(最大直径≤1 cm)良、恶性的诊断价值。方法回顾性分析2012年9月至2018年12月在上海交通大学医学院附属新华医院就诊的160例乳腺小肿块患者的术前乳腺MRI检查图像,其中良性疾病组111例,恶性疾病组49例。比较2组病灶位置、形态学特征、时间-信号强度曲线(TIC)、T2WI信号特征和表观扩散系数(ADC)的差异。年龄的组间比较采用Student’s t检验,病灶大小和ADC值的组间比较采用Mann-Whitney U检验,计数资料(病灶位置、周围脂肪征、形态、边缘、内部强化和TIC类型)组间比较采用χ²检验,伴对侧同时恶性肿瘤比例和T2WI信号特征的组间比较采用Fisher确切概率法。计数资料亚组内两两比较采用Bonferroni校正。绘制年龄和ADC值的受试者工作特征曲线,多因素分析采用二元logistic回归,使用“Forward:LR”法,建立良、恶性疾病诊断模型,计算该模型的曲线下面积、敏感度、特异度、阳性预测值、阴性预测值和正确率,输出预测模型列线图。结果(1)单因素分析:良性组和恶性组的周围脂肪征、病灶边缘、内部强化类型、TIC类型、T2WI信号特征及ADC值比较,差异均有统计学意义(χ²=13.083、11.224、7.628、14.060、21.892;P<0.001、0.004、0.006、0.001、<0.001;Z=-3.952,P<0.001)。(2)多因素分析:年龄>50岁、周围脂肪征阳性、T2WI上略低信号或周边高信号、ADC值≤1.22×10^-3mm²/s是提示乳腺癌的独立危险特征(OR=6.728,95%CI:2.123~21.318,P=0.001;OR=5.545,95%CI:1.306~23.533,P=0.020;OR=31.110,95%CI:2.167~446.576,P=0.011;OR=13.794,95%CI:2.096~90.790,P=0.006;OR=5.802,95%CI:1.350~24.938,P=0.018)。(3)鉴别诊断模型:联合上述特征的诊断模型对乳腺小肿块鉴别诊断的敏感度、特异度、阳性预测值、阴性预测值及正确率分别为89.2%(33/37)、69.4%(59/85)、55.9%(33/59)、93.6%(59/63)和75.4%(92/122)。结论乳腺良、恶性小肿块的MRI图像特征表现重叠,单一特征鉴别诊断较困难。联合患者年龄、周围脂肪征、T2WI信号特征和ADC值有助于提高诊断正确率。     

磁共振扩散加权成像鉴别诊断良恶性乳腺肿瘤价值的Meta分析

目的:对磁共振扩散加权成像鉴别诊断良恶性乳腺肿瘤的价值进行Meta分析。方法:选择对关于磁共振扩散加权成像鉴别诊断良恶性乳腺肿瘤的国内外文献(2005年-2013年)进行检索与分析,分析磁共振扩散加权成像鉴别诊断的敏感度与特异度。结果:检索符合纳入标准的为60篇文章,其中a级文献10篇。所有文献资料都有很好的异质性,偏倚性也比较好。磁共振扩散加权成像鉴别诊断的平均敏感度与特异度分别为92.0%和79.5%。结论:磁共振扩散加权成像鉴别诊断良恶性乳腺肿瘤有很好的敏感度,特异度也比较好。     

Recent progress of diffusion weighted magnetic resonance imaging in assessment of tumor in the body

In the last couple of years, as the development of new imaging techniques, diffusion-weighted magnetic resonance imaging （DW-MRI） has been applied increasingly in the evaluation of various diseases in the body, and has been adopted frequently as an imaging tool in clinical tumor assessment. As a completely non-invasive, highly sensitive, well-tolerated and relatively low cost technique, diffusion-weighted imaging （DWI） can supply both quantitative and qualitative information at the cellular level by exploring irregular diffusion motion of water molecules within tissues in the body. In this article, we summarized the recent application and reliability of DWI in tumor evaluation including tumor detection, tumor features, and outcome of early treatment response.     

腮腺原发良、恶性肿瘤CT表现的比较分析

背景与目的:腮腺富含脂肪组织,与周围骨骼肌肉形成天然对比,CT能够较好地评价腮腺病变及其对周围结构的侵犯情况。术前CT对腮腺良恶性肿瘤的准确判断与评估能够有效指导临床诊断与治疗。本研究探讨CT对腮腺原发良、恶性肿瘤的鉴别诊断价值,提高术前定性诊断精确性。方法:回顾性分析了经病理证实的17例腮腺原发良性肿瘤和15例恶性肿瘤的CT表现,并进行统计学处理。32例患者均行CT增强扫描。由两位资深放射科医生进行阅片分析。结果:本组良性肿瘤(14/17)多表现为圆形或类圆形肿块,而恶性肿瘤(9/15)以分叶状或不规则肿块影常见,P=0.027。良性肿瘤(6/17)常出现散在小片状低密度灶,恶性肿瘤组未见散在片状低密度灶,P=0.019。良性肿瘤(13/17)大部分边缘光滑清晰,恶性肿瘤(11/15)多表现为边缘毛糙模糊,P=0.012。个别良性肿瘤(2/17)与胸锁乳突肌分界欠清,恶性肿瘤部分(9/15)侵犯咬肌或胸锁乳突肌,P=0.008。良性肿瘤均未见肿大淋巴结及血管神经侵犯,恶性肿瘤6例(6/15)出现肿大淋巴结,4例(4/15)出现神经血管侵犯,P值分别为0.006和0.038。结论:肿块的形态、边缘、内部低密度灶分布以及与邻近咬肌及胸锁乳突肌分界情况是腮腺良恶性肿瘤的重要鉴别点,淋巴结转移及血管神经侵犯是恶性肿瘤的特异性征象。综合多指标观察分析,CT能对大多数腮腺良、恶性肿瘤做出正确诊断。