腮腺基底细胞腺瘤和多形性腺瘤的双期增强CT的诊断价值

 目的 探讨腮腺基底细胞腺瘤(basal cell adenoma,BAC)与多形性腺瘤(pleomorphic adenoma ,PA)的CT特征及鉴别诊断。方法 回顾性分析首都医科大学大兴教学医院2014-01至2018-06经手术病理证实的腮腺BAC患者14例的CT影像及临床资料,并与同期收集的56例腮腺PA进行对比分析。结果 BAC和PA患者表现为腮腺浅叶内单发、形态规则、边界清楚病灶,部分病灶内可见囊变区,BAC平扫CT值(25.9±7.1)HU,与PA的平扫CT值(31.3±10.1)HU相比,差异无统计学意义;增强扫描表现为持续明显强化,BAC动脉期强化幅度值、静脉期强化幅度值分别为(64.3±48.0)HU、(59.4±17.5)HU,均明显高于PA(23.0±13.9)HU、(36.3±15.4)HU,差异有统计学意义(P<0.01)。结论 腮腺BCA与PA均具有单发、好发浅叶、边界光整、可囊变等特征; CT双期增强扫描有助于两者诊断及鉴别诊断。     

腮腺基底细胞腺瘤的CT和超声表现

目的：探讨腮腺基底细胞腺瘤的临床与CT、超声表现特点。方法回顾性分析18例经手术病理学证实的腮腺基底细胞腺瘤患者。全部病例均行CT平扫,8例进一步行增强扫描;14例行超声检查。分析患者性别、年龄、病程、临床表现及病灶数目、部位、大小、形态、密度与增强特征（CT）、内部回声与血流分布情况（超声）。结果18例患者,共19个病灶,其中仅1例单侧2个病灶;病灶大小约6-31mm,平均为（19．1±6．5）mm。18个病灶位于腮腺浅叶,其中表浅区与深部各9个,最大径平均值分别为（17．2±5．2）mm、（23．0±5．4）mm;1个病灶位于深叶,最大径26mm;6个病灶强化显著,3个病灶轻度强化。13个病灶声像图上见后方回声增强,各6个病灶内见液性暗区与血流信号。结论基底细胞腺瘤的CT与声像图有一定特征性,结合临床特点对于肿瘤的定性诊断有很大帮助;超声较CT平扫更能显示病灶的轮廓及内部囊变区。     

Myoepithelioma of the parotid gland: CT imaging findings

BACKGROUND AND PURPOSE: Myoepitheliomas (MEs) are rare tumors of the parotid gland. Only a few case reports describing CT imaging features of ME have been published. The aim of this study was to describe and characterize the CT findings of MEs of the parotid gland.MATERIALS AND METHODS: We retrospectively reviewed CT images of ME with pathologic correlation in 10 cases (4 men and 6 women; age range, 30–70 years) collected between August 2003 and October 2007 from our pathologic database. All of the CT images were retrospectively evaluated with respect to the location, size, marginal morphology, enhancement, and enhancement pattern by 2 experienced radiologists.RESULTS: Nine tumors were located in the superficial lobe of the parotid gland, and 1 was located in the tail of parotid gland. All of the tumors abut on the capsule of the gland. Nine tumors had well-defined margins with lobulations in 5 patients. Two cases showed homogenous enhancement. In the other 8 cases, the enhancement was inhomogeneous because of enhancing nodules and nonenhancing areas of linear bands, slitlike-shaped or of cystic configuration.CONCLUSION: CT imaging findings of MEs were well circumscribed, enhancing the mass lesion with smooth or lobulated margins, located chiefly in the superficial lobe and abutted on the capsule of the gland. They may contain enhancing nodules and nonenhancing areas of linear bands, slitlike-shaped or of cystic configuration. Although MEs are a rarity, they should be suspected when a tumor shows all of the characteristics noted here.

Myoepithelioma (ME) is a benign salivary gland tumor composed almost exclusively of sheets, islands, or cords of cells with myoepitheliomal differentiation.¹ MEs account for 1.5% of all of the tumors in the major and minor salivary glands,² and 40% arise in the parotid glands.² The use of CT for the assessment of parotid tumors is well established. Although much has been written on the CT appearance of the pleomorphic adenomas and Warthin tumors,^3-9 the detailed imaging features of MEs of the parotid gland have not been described previously in the English language literature. In this study, we describe the CT appearance of 10 histologically proven cases of MEs of the parotid gland.     

Basal cell adenoma of the parotid gland: dynamic CT and MRI findings

Imaging findings in basal cell adenoma (BCA) of the parotid gland have been rarely reported. We report dynamic CT and MRI findings of BCA in the parotid gland in a 78-year-old woman. Dynamic CT study demonstrated strong multinodular contrast enhancement in the early phase which decreased gradually in the later phases. The mass was isointense on T(1) weighted and hyperintense on T(2) weighted MR images with a central haemorrhagic-necrotic component. The microscopic findings were consistent with membranous type BCA.     

腮腺少见肿瘤增强CT表现特征临床研究

目的分析腮腺少见肿瘤的增强CT表现特征。方法选取2010年1月至2016年1月成都医学院第一附属医院收治20例腮腺少见肿瘤患者作为观察对象,通过患者增强CT扫描影像分析患者肿瘤的位置、大小、形态及病变密度与周围组织间的关系。结果基底细胞癌:5例患者肿瘤均位于腮腺浅叶,且边缘清晰,病变组织中呈囊性病变,增强CT扫描表现出不均匀中度-明显增强趋势,肿块组织边缘或内部均有结节状强化影存在,3例患者伴淋巴结增大的特征;肌细胞上皮瘤:3例患者肿瘤位于腮腺浅叶,多伴随小囊变,仅1例患者病灶中出现小点状钙化影,实性组织增强CT扫描表现出中度-明显增强,多伴动脉期强化结节及肿瘤边缘显著强化等特征;脉管瘤:主要结构为软组织肿瘤,肿瘤体积较大,密度表现为均匀或不均匀,可在腮腺表面观察到静脉石突出,增强CT扫描后呈现轻度-明显增强;淋巴上皮囊肿:囊肿中存在粘稠囊液,呈高密度表现;腮腺脂肪瘤:主要为脂肪密度肿块,边界清晰,无增强表现,病变组织内部可观察到纤维分隔的现象;软骨肉瘤:主要以囊性肿瘤为主,且伴随边缘钙化、骨化成分的肿块。结论少见腮腺肿瘤具有一定的增强CT影像学特征,且与肿瘤的发生机制有一定的相关性,增强CT在诊断腮腺少见肿瘤中具有较好的应用效果,值得在临床推广应用。     

Basal cell adenoma of the parotid gland: MR imaging findings with pathologic correlation

BACKGROUND AND PURPOSE: Basal cell adenomas (BCAs) are rare tumors of the parotid gland. Only a few case reports describing MR imaging features of BCA have been published. The aim of this study was to describe and characterize the MR findings of BCAs of the parotid gland. MATERIALS AND METHODS: We retrospectively reviewed MR images of BCA with pathologic correlation in 8 cases (2 men and 6 women; age range, 52-82 years) collected between January 1992 and August 2004 from our pathologic data base. All MR images were retrospectively evaluated with respect to the marginal morphology, signal intensity (SI), and enhancement behavior by 2 experienced radiologists. RESULTS: On pathologic examination, 5 tumors were solid type, 2 were trabecular type, and 1 was membranous type. All of the tumors were well circumscribed with smooth contours. Cystic changes were seen in 4 cases. On T1-weighted images (T1WI), 7 tumors showed homogeneously low SI equal to muscle and one showed heterogeneously low SI. On T2-weighted images (T2WI), all of them showed slightly lower SI than that of surrounding parotid tissue. On gadolinium-enhanced T1WI, 6 tumors demonstrated moderate enhancement and one demonstrated strong enhancement (membranous type). Dynamic studies were performed in 4 cases. All showed rapid and prolonged enhancement. CONCLUSION: MR imaging findings of BCA were well-defined and smooth marginal morphologies, relatively low SI on both T11W and T2WI, and rapid and prolonged enhancement on dynamic study. Although BCAs are rare, they should be suspected when a tumor shows all of the characteristics noted here.     

腮腺病变的CT诊断

目的探讨腮腺良、恶性病变的CT特点。方法回顾性分析52例经手术病理及临床证实的腮腺病变的CT表现,其中良性肿瘤29例,恶性肿瘤13例,结核4例,慢性腮腺炎6例。结果52例中,48例表现为腮腺内或腮腺区肿块,良性肿瘤形态规则,边界清楚,占82.8%(24/29);恶性肿瘤形态不规则,边界模糊不清,占76.9%(10/13);腮腺结核表现为密度不均、边界较模糊的结节或肿物,并有结节样钙化和腮腺周围淋巴结肿大,病灶及肿大淋巴结均呈环形强化;4例弥漫性炎症表现为一侧或双侧腮腺弥漫性肿大,密度增高;2例为局限炎症,呈形态不规则肿块状,边界不清。结论CT扫描对腮腺病变定位敏感性为100%,对各类腮腺病变的定性诊断有重要价值,增强扫描可提高其定性诊断率。     

腮腺基底细胞腺瘤的CT和MRI特点

目的 探讨腮腺基底细胞腺瘤的CT和MRI表现特点.方法 回顾性分析经手术病理证实的9例腮腺基底细胞腺瘤的CT和MRI的影像特点(6例CT检查,3例MR检查).9例中男4例,女5例,中位年龄58岁(40～79岁).对肿瘤的部位、大小、形态、边缘、CT密度或MRI信号及强化形式进行分析.结果 9例患者均为单发肿瘤,8例位于腮腺浅叶,1例位于腮腺深叶.9个肿瘤中7个为类圆形,无分叶;2个为长椭圆形,有浅分叶.9个肿瘤边缘均光滑清楚;MR检查3例,2个肿瘤周边见T2wI低信号的包膜,1个肿瘤周边见一较薄的T2WI高信号环.3个肿瘤MRI均表现为长T1、短T2信号,增强后呈不均匀轻、中度强化,内见裂隙样、小片状低信号,并出现延迟强化,1例见壁结节;CT检查6例,平扫肿瘤均表现为低密度,其中4个肿瘤CT强化共同特点均为薄壁环形强化,且有大小不等的壁结节,肇结节呈中～重度强化(平均CT值增加为65.5 HU),另外2个呈均匀中度强化.结论 老年女性患者腮腺浅叶内单发边界清楚病灶,CT增强表现为薄壁环形强化且有壁结节,MRI表现为长T1、短T2信号,强化内见裂隙样、小片状低信号且出现延迟强化,要考虑基底细胞腺瘤的可能.     

64排螺旋CT双期增强扫描诊断腮腺肿瘤的影像病理分析

目的：探讨腮腺肿瘤的CT增强特点及其病理基础,提高对不同病理类型腮腺肿瘤的影像特征认识。方法：搜集本院30例经手术病理证实的腮腺肿瘤的CT检查资料,所有病例术前均行64排螺旋CT平扫和双期增强扫描。分析肿瘤的CT增强特征,测量平扫和双期增强的CT值,并进行统计分析。结果：各类型腮腺肿瘤平扫均为等或稍低密度结节,其中腺淋巴瘤平扫密度最高,腺淋巴瘤和基底细胞瘤可见明显的囊变。增强特点：多形性腺瘤表现为缓慢持续强化,腺淋巴瘤表现为早期显著强化及快速流出,基底细胞瘤表现为早期显著持续强化,恶性肿瘤表现为延迟显著持续强化;腺淋巴瘤的动脉期CT值明显高于较其他类型的肿瘤,差异有统计学意义（P〈0.05）,各类型肿瘤静脉期CT值差异无统计学意义（P〉0.05）。结论：腮腺多形性腺瘤、腺淋巴瘤、基底细胞瘤及恶性肿瘤各有其不同的强化特点。腮腺良恶性肿瘤的动态增强特点有明显的差异。     

Basal cell adenoma of the parotid gland: characteristics of 2-phase helical computed tomography and magnetic resonance imaging

OBJECTIVE: The goal of this study was to report the radiologic characteristics of basal cell adenoma of the parotid gland, which is a relatively rare neoplasm. METHODS: A radiology and otolaryngology specialist reviewed the 2-phase helical computed tomography (CT) (n = 6) and/or magnetic resonance (MR) imaging (n = 2) scans of 7 patients with basal cell adenoma. The authors evaluated the imaging characteristics, including tumor size, location, contour and margin, internal density or signal intensity, contrast enhancement pattern, and presence of calcification. The imaging features were then analyzed and correlated with the pathologic findings. RESULTS: All the tumors presented as small (less than 3 cm), well-encapsulated, round or oval masses on CT or MR imaging. On the 2-phase CT scan, the mostly solid-looking tumors (n = 4) showed marked contrast enhancement on the early phase, and there was a subsequent decrease in attenuation on the delayed phase. These tumors were classified as the solid subtype on histologic examination. Meanwhile, the tumors with large cystic areas (n = 2) showed gradual and additional enhancement on the delayed phase and were classified as the tubular or trabecular subtype on pathologic evaluation. There were small spots of low attenuation in the tumors of the solid subtype, which were proved to be intratumoral microcysts in the pathologic correlation. Calcification was found in a tumor. CONCLUSIONS: Basal cell adenomas of the parotid gland present as small well-marginated tumors and appear as masses with central large cysts or solid masses with microcysts on CT and MR imaging scans. Basal cell adenomas of the parotid gland had at least 2 different enhancement patterns on the 2-phase helical CT scans, and the enhancement patterns and imaging architecture were related to the histologic subtype of the tumors.     

腮腺恶性肿瘤的CT表现

目的探讨CT在评价不同病理类型腮腺恶性肿瘤中的作用,并评价U线（通过下颌后静脉最背侧点与颈椎骨同侧最背侧点的连线）在腮腺肿瘤定位中的应用价值。资料与方法回顾性分析32例经病理证实的腮腺原发恶性肿瘤的CT表现,并用U线定位分析其中经手术治疗的27例肿瘤的深浅叶划分结果。结果（1）低度恶性腮腺上皮源性肿瘤表现为边界清晰或部分清晰、形态较规则、常见小片状坏死区的肿块,强化明显,较少累及两叶。（2）中高度恶性腮腺上皮源性肿瘤表现为边界不清晰、形态不规则、密度均匀或较大片的坏死区的肿块,强化较明显,常累及两叶并浸润周围组织,淋巴结转移多见。（3）非上皮源性恶性淋巴瘤表现为密度均匀、边界清楚、常单侧或双侧多发的肿块,轻度强化。（4）使用U线分析,腮腺肿瘤定位的符合率为70．4％。结论CT在区分不同生物学行为及组织学类型的腮腺恶性肿瘤上有一定的作用。U线在恶性腮腺肿瘤的定位评价中有一定的局限性,综合茎突乳突问区及下颌后静脉受侵情况,评价则更准确,符合率可提高到88．9％。     

甲状腺髓样癌的CT表现及病理基础

目的：探讨甲状腺髓样癌（MTC）的CT表现特点和病理基础。方法：回顾性分析了28例经手术病理证实的MTC的CT表现，并与病理所见作对照研究。结果：肿瘤侵及一叶甲状腺22例，双叶6例。5例密度不均匀，23例表现为均匀低密度实质性占位（弥漫型19例）；25例增强扫描，17例原发灶轻度强化。淋巴结转移20例，其中行增强扫描的18例转移淋巴结多强化明显。对照病理，5例密度不均匀者镜下见囊变坏死（3例）或肿块内夹有未被侵犯的甲状腺组织（2例），而23密度均匀者未见上述改变，肿瘤组织中细胞分布大致均匀紧密，转移淋巴结内血管丰富。结论：MTC的CT表现以弥漫性均匀低密度肿块、轻度增强、多累及一叶甲状腺为特点，转移淋巴结以强化为特征。     

腮腺原发恶性肿瘤的CT表现

目的：分析腮腺各类型原发恶性肿瘤的CT表现，了解其影像学特点，资料与方法。分析经手术及病理证实的腮腺原发恶性肿瘤19例，包括粘液表皮样癌8例，腺泡细胞癌及腺癌各3例，鳞状细胞癌及恶性混合瘤各2例，腺样囊性癌1例。结果：临床有面神经受累症状者7例，其中6例肿瘤侵及深，浅二叶。19例中，5例肿物呈圆形或椭圆形，14例呈不规则形；6例边缘清楚，13例边缘不清楚并伴有不同程度的周围结构受侵。17例行增强扫描，肿瘤均有不同程度的强化，其中10例明显强化。肿瘤密度均匀2例，不均匀15例，内部有不同形态的低密度区，其中4例中央有大片低密度坏死，9例合并有颈部淋巴结肿大。结论：面神经受累症状为腮腺恶性肿瘤的临床特点，如肿瘤侵及深，浅二叶时诊断更为可靠；肿物边缘不规则，边界不清楚，明显强化，内部密度不均匀以及颈部淋巴结肿大为腮腺原发恶性肿瘤的影像学特点。     

CT and MR findings of basal cell adenoma of the parotid gland

We report a case of basal cell adenoma in the left parotid gland. A 34-year-old woman presented with a non-tender mass in the left parotid gland. She had first noted it 7- years previously, and it had been gradually increasing in size. The tumor was well-circumscribed with a smooth contour. On noncontrast-enhanced CT, the tumor showed homogeneous soft tissue attenuation. No cystic portion or calcification was seen. The tumor showed homogeneous moderate enhancement on contrast-enhanced CT. Capsule-like ring enhancement was demonstrated. On T1-weighted MR imaging, the tumor was homogeneously hypointense to the surrounding parotid tissue and isointense to muscle. On T2-weighted imaging the tumor was homogeneously hyperintense to muscle but slightly hypointense to the surrounding parotid tissue. On Gd-enhanced T1-weighted imaging, the tumor demonstrated homogeneous moderate enhancement. Capsule-like ring enhancement was also demonstrated. Salivary (technetium-99m-pertechnetate) scintigraphy did not show any uptake in the tumor.     

Myopericytoma Involving the Parotid Gland as Depicted on Multidetector CT

Myopericytoma is a newly proposed subgroup of perivascular tumors in the World Health Organization classification of soft tissue tumors. In this study, we report a case of a benign myopericytoma with detailed multidetector CT (MDCT) findings in the parotid gland, a location that has not been described for this type of tumor previously. The clinical presentation, imaging features, histopathological and immunohistochemical findings, and the differential diagnosis with other tumors in the parotid gland are described and reviewed.     

腮腺基底细胞腺瘤的CT、US诊断价值

目的分析腮腺基底细胞瘤的CT、Us影像表现,探讨CT、US检查对腮腺基底细胞瘤的诊断价值。方法回顾性分析18例腮腺基底细胞瘤的CT、Us表现及临床相关资料,所有病例均经手术病理证实。18例均行CT及us检查,CT检查均行平扫加增强扫描,其中ll例行延迟1～1．5min扫描。结果18例中,男性3例,女性15例,男女比例1：5;中位年龄52岁,共发现基底细胞瘤21个。单侧单发15例,其中1例合并对侧腺淋巴瘤;单侧多发2例;双侧多发1例。15个病灶发生于腮腺浅叶。加个病灶跨叶分布。6个病灶发生于左叶,15个病灶发生于右叶。21个病灶外形均规整,边界清,包膜完整;11个病灶发生囊变,其中6例囊变率达80％以上;11个病灶囊变区边缘可见壁结节,7个病灶囊变边缘可见花环征。CT增强扫描16个病灶实性部分明显强化,4个病变中度强化,1个病变轻度强化。9个病灶延迟强化减退,3个病灶延迟强化。超声发现11例混合型病变,回声不均匀,内可见大小不一的液性暗区,15个病灶CDFI显示内部和／或周边血流信号丰富,呈短条状,4个病灶可见散在点状血流信号,4个病灶未见明显血流信号;9个病灶回声均匀,12例回声不均匀,其中2例病灶后方回声增强。结论腮腺基底细胞瘤的CT、US影像表现具有一定特征,结合患者的性别、年龄等,有助于鉴别诊断。     

腮腺基底细胞腺瘤的CT与MRI表现

目的:探讨腮腺基底细胞腺瘤(BCA)的CT和MRI表现。方法:回顾性分析10例腮腺BCA的CT和MRI表现。10例中男3例,女7例;右侧腮腺4例,左侧6例。结果:10例肿瘤均为单发,肿瘤最长径平均为2.4cm。10例肿瘤中不规则形或深分叶状2例,圆形或类圆形8例;边缘均光滑清楚。MRI检查2例,表现为长T1、短T2信号实性肿块,伴稍低信号包膜,增强扫描后病灶呈均匀明显强化。CT检查8例:6例呈实性,2例呈囊实性、内有大片液化囊变,实性部分明显强化。结论:腮腺BCA的CT和MRI表现有一定特征,结合临床,有助于本病的诊断和鉴别诊断。     

头颈部嗜酸性淋巴肉芽肿的影像及病理学分析

目的 探讨头颈部嗜酸性淋巴肉芽肿(KD)的影像表现及病理特征,以提高对该病的术前诊断率。方法 回顾性分析8例经病理证实的头颈部KD患者的临床影像及病理表现。结果 8例KD患者中,单发与多发各4例;部位:腮腺6例、口底(颌下腺区)1例、眼睑1例,其中2例累及腹股沟。CT和MRI征象:①累及腮腺者(4例):患侧腮腺、面部弥漫性增大,结节边界欠清或较清,密度略高于腮腺,T₁加权像多为等信号,T₂加权像信号则多为等、低信号,增强扫描有不同程度强化;②累及头颈部其他部位(如颌下腺区、眼睑等)者:病变密度、信号、强化程度亦与累及腮腺者类似,但可有周围组织的受累(如颅骨);③周围淋巴结常不同程度受累、增大,密度、信号均匀,边界清楚,无坏死,无融合;往往累及局部皮下组织,邻近皮肤增厚。病理:KD组织成分基本一致,均由淋巴细胞、嗜酸性粒细胞、小血管和纤维组织以不同比例组成。结论 KD有一定的好发部位和临床特点,结合影像学检查与病理分析,可大大提高其术前诊断的正确率。     

Tuberculosis of the parotid gland: computed tomographic findings

Background: Tuberculosis (TB) of the parotid gland is rare, even in endemic regions. Approximately 100 cases have been reported in the English literature. The computed tomographic (CT) features, however, have seldom been studied.

Purpose: To determine the diagnostic CT features of tuberculosis of the parotid gland.

Material and Methods: CT studies of four histologically proven cases of tuberculosis of the parotid gland were retrospectively reviewed.

Results: A total of 15 enlarged lymph nodes were found in the superficial lobes of the parotid glands. The nodes were arranged linearly within the gland. Enhancement patterns included homogeneous enhancement (9/15, 60%), homogeneous enhancement with eccentric microcysts (3/15, 20%), and thick-walled rim enhancement with central lucency (3/15, 20%). Thickened adjacent fascial plane and platysma were seen in two patients. Ipsilateral cervical lymphadenopathy was seen in all patients.

Conclusion: In patients presenting with unilateral parotid nodules, TB should be considered when linearly arranged enhancing nodules are demonstrated in the superficial lobes of the glands on CT scan.