多层螺旋CT双期扫描腮腺肿瘤的临床价值分析

目的探讨腮腺肿瘤的多层螺旋CT图像特点。方法对60例腮腺肿瘤的临床资料及CT图像进行分析,并分别测量平扫和双期增强的CT值,判断其强化程度。结果 60例患者中发现良性肿瘤57例,恶性肿瘤3例。腺淋巴瘤发病平均年龄最高,且均为中老年男性。混合瘤以中年女性多见,发病平均年龄各组最低。腺淋巴瘤平扫密度最高。增强特点:腺淋巴瘤表现为早期显著强化及快速流出,多形性腺瘤表现为延迟式强化,基底细胞瘤表现为显著持续强化,内见点状及裂隙状低密度;表皮粘液样癌增强表现缺乏特异性。结论 CT能对腮腺肿瘤进行准确定位,不同病理类型的肿瘤在发病年龄、部位,平扫及增强后的强化程度及方式有一定的特异性,但也存在不同程度的交叉。     

腮腺基底细胞腺瘤的CT表现与鉴别诊断

目的:探讨腮腺基底细胞腺瘤(BCA)的CT表现特点。方法:回顾性分析经手术病理证实的9例腮腺BCA病例的CT资料,对病变的部位、形态、大小、数目、CT平扫和双期增强特征进行分析,并与同期搜集的31例腮腺多形性腺瘤和19例腮腺腺淋巴瘤进行比较。结果:9例BCA均为单发病灶,6例位于腮腺浅叶,3例病灶跨浅叶及深叶。病灶均边缘清楚,4例肿瘤内见囊变,其中3例囊变区≥50%,1例瘤体边缘见弧形钙化。所有病例增强双期均显著强化,动脉期BCA增强幅度高于多形性腺瘤,静脉期BCA增强幅度高于多形性腺瘤和腺淋巴瘤,两者差异均有统计学意义(P<0.01)。结论:腮腺BCA的CT表现具有一定特征性,结合临床特点有助于作出定性诊断。     

腮腺腺淋巴瘤与多形性腺瘤的双期增强CT表现与鉴别

目的通过观察腮腺腺淋巴瘤与多形性腺瘤的CT影像学表现,探讨腮腺腺淋巴瘤与多形性腺瘤的双期增强CT表现及其鉴别价值。方法回顾本院经手术及病理证实的16例腮腺腺淋巴瘤(A组)患者临床资料,分析其CT影像学表现,并与同期23例腮腺多形性腺瘤(B组)患者比较。结果 A组腮腺腺淋巴瘤:多发于50岁以上男性,多位于腮腺后下象限,边界清楚光整,呈均匀稍高密度或伴囊变坏死低密度,增强扫描多呈"快进快出"表现;B组多形性腺瘤:多发于中年,多位于腮腺非后下象限,边界清楚光整,呈均匀稍高密度或伴囊变坏死及钙化,增强扫描呈缓慢渐进性强化。A、B两组患者在病灶部位、分叶状病灶所占比例、增强扫描后CT值上升平均值比较,两组差异具有显著性(P<0.05);病灶大小、密度对比,两组无显著性差异(P>0.05)。结论腮腺腺淋巴瘤与多形性腺瘤的双期增强CT表现具有特征性,对两者的鉴别具有重要价值。     

腮腺多形性腺瘤与腺淋巴瘤的CT影像特征及对比分析

目的：探讨腮腺多形性腺瘤与腺淋巴瘤的CT影像特点,提高对两者的鉴别诊断能力。方法回顾性研究经手术病理证实的13例多形性腺瘤及9例腺淋巴瘤的CT表现,并做对比分析。结果13例多形性腺瘤均为单发,11例位于腮腺非后下象限,增强11例表现为持续性或延迟强化,呈“慢进慢出”改变;9例腺淋巴瘤3例多发共13个病灶,9个病灶位于腮腺后下象限,增强9个病灶动脉期显著强化,延迟期强化减退,呈“快进快出”表现。结论腮腺多形性腺瘤与腺淋巴瘤 CT 影像表现各有特点,掌握各自特征性影像表现并结合临床资料,绝大多数病灶术前可以做出正确诊断。     

MSCT双期增强扫描结合彩超对腮腺肿瘤的诊断价值

目的 研究多层螺旋CT(MSCT)双期增强扫描结合彩色多普勒血流显像(CDFI)对腮腺良恶性肿瘤的诊断价值.方法 分析手术病理证实的腮腺多形性腺瘤12例、腺淋巴瘤10例、缺乏恶性形态学CT表现特征的恶性肿瘤13例的术前MSCT双期增强扫描和CDFI影像资料,研究CT对腮腺肿瘤的诊断价值和限度以及CDFI诊断恶性肿瘤的阻力指数(RI)阈值,评价2种影像学手段相结合的诊断价值.结果 ①腺淋巴瘤与恶性肿瘤和良性多形性腺瘤的双期增强CT值均存在显著统计学差 异(P＜0.05),而后二者CT值差异无统计学意义(P＞0.05);②MSCT双期增强扫描对腺淋巴瘤的定性诊断敏感度和特异度极高(分别为90%和100%),对良性多形性腺瘤和恶性肿瘤的定性诊断敏感度、特异度较低(分别为60.00%、65.21%和46.15%、59.10%);以RI≥0.77作为CDFI诊断恶性肿瘤的阈值标准,诊断敏感度和特异度分别为92.30%、83.33%; ③采用MSCT双期增强扫描结合CDFI对恶性肿瘤的鉴别诊断敏感度、特异度分别为84.62%、100%.结论 MSCT双期增强扫描结合CDFI能弥补前者的不足,明显提高缺乏恶性形态学CT表现特征的腮腺恶性肿瘤的诊断准确度.     

双源CT对腮腺腺淋巴瘤及多形性腺瘤的诊断及鉴别诊断价值

目的 :探讨双源CT对腮腺腺淋巴瘤与多形性腺瘤的诊断及鉴别诊断价值。方法 :搜集33例,其中经手术、病理证实为腮腺腺淋巴瘤17例共22个病灶,腮腺多形性腺瘤16例共17个病灶,均完成双源CT平扫及增强扫描。结合病理,对其临床、影像资料进行分析和比较。结果:腮腺腺淋巴瘤与腮腺多形性腺瘤在发病部位、生长轴线、肿瘤内低密度或囊变坏死、平扫及增强扫描CT值、肿瘤内或周边血管影等方面差异均有统计学意义(均P0.05);在肿瘤形态、大小、左右叶分布方面差异均无统计学意义(均P0.05)。结论 :双源CT除能显示腮腺多形性腺瘤及腺淋巴瘤的数目、部位、形态及周围结构情况,尤其对肿瘤内低密度组织成分或囊变坏死、增强血管影等显示有较好优势,对两者具有较好的鉴别能力。     

腮腺基底细胞腺瘤与腺淋巴瘤的CT表现

目的 :探讨腮腺基底细胞腺瘤与腺淋巴瘤的CT特点,为两者的诊断与鉴别诊断提供依据。方法 :回顾性分析我院经手术及病理证实的腮腺基底细胞腺瘤12例、腺淋巴瘤23例,对患者年龄、肿瘤最大径、平扫及增强扫描CT值进行分析对比。结果:腮腺基底细胞腺瘤12例均为单侧,女性好发,腺淋巴瘤一侧或双侧多发,男性好发;腮腺基底细胞腺瘤发病年龄较腺淋巴瘤小(P0.05);基底细胞腺瘤与腺淋巴瘤的最大径差异无统计学意义(P0.05)。腮腺基底细胞腺瘤平扫期CT值较低,增强扫描动脉期和静脉期明显强化、CT值较高;腺淋巴瘤的平扫期CT值较高,增强扫描动脉期和静脉期呈轻中度强化、CT值较低;两者平扫、增强扫描CT值差异均有统计学意义(均P0.05)。结论:腮腺基底细胞腺瘤和腺淋巴瘤的发病除具有性别、年龄差异外,CT平扫和增强扫描有明显的特征,可对两者的定性诊断提供参考。     

腮腺基底细胞瘤的CT影像诊断及鉴别

目的 探讨腮腺基底细胞瘤(BCA)的CT特征及鉴别诊断.方法 回顾性分析经手术病理证实的9例腮腺BCA患者的CT表现;9例均行CT平扫和增强;并与腮腺混合瘤、腺淋巴瘤及黏液表皮样癌的CT表现进行对照.结果 9例患者均为单发.CT平扫均表现为腮腺内稍高密度影,呈类圆形,境界清晰,CT值约34～53 HU;8例病灶体积较小,最大径0.92 ～ 2.74 cm,均位于腮腺浅叶;1例体积较大,最大径3.21 cm,同时累及腮腺深、浅叶;增强扫描,肿瘤实质部分呈明显强化,动脉期CT值约83 ～ 106 HU,静脉期强化不消退.CT平扫时,BCA与混合瘤、腺淋巴瘤及黏液表皮样癌的CT值无统计学差异(P＞0.05);动脉期:BCA肿瘤实质部分的强化程度与腺淋巴瘤无明显差异(P＞0.05),但均高于混合瘤及黏液表皮样癌(P＜0.05);静脉期:BCA肿瘤实质部分的强化程度高于腮腺混合瘤、腺淋巴瘤及黏液表皮样癌(P＜0.05).结论 BCA作为一种相对少见的腮腺良性肿瘤,好发于老年女性;影像学表现为位于腮腺浅叶的单发病灶,密度不均,边缘清晰,增强扫描呈“快进慢出”表现;最终确诊须依靠病理学.     

腮腺腺淋巴瘤与多形性腺瘤的MSCT征象对比分析

目的回顾性对比分析腮腺腺淋巴瘤与多形性腺瘤的MSCT影像特征。方法经手术及病理证实的24例腮腺腺淋巴瘤与35例多形性腺瘤,分析其临床及影像学资料,对肿瘤数量、发生部位、形态、边界、平扫密度、CT强化特征等进行对比分析。结果腮腺腺淋巴瘤与多形性腺瘤的肿瘤数量、病灶形态、边界差异无统计学意义(P0.05);病灶发生于后下象限、平扫密度较高、早期显著强化更常见于腮腺腺淋巴瘤,差异有统计学意义(P0.05)。3种阳性单一征象中,发生于后下象限敏感度最高(90.3%),早期显著强化特异度最高(92.4%);两种联合征象中,发生于后下象限+平扫密度较高敏感度最高(83.4%),发生于后下象限+早期显著强化特异度最高(94.4%);3种征象联合时,诊断腺淋巴瘤的敏感度和特异度分别为63.1%、96.4%。结论发生部位、平扫密度及早期显著强化在腮腺腺淋巴瘤与多形性腺瘤的MSCT影像鉴别中具有较高的特异性,多种征象联合应用大多数病灶术前可作出正确诊断。     

Value of routine MRI in combination with DWI in the diagnosis of parotid gland tumors

目的:探讨常规MRI联合DWI对腮腺常见肿瘤的诊断价值.方法:回顾性分析经病理证实的62例腮腺肿瘤的MRI图像,根据其DW1图行ADC图重建,测量肿瘤的ADC值.按发病率将62例病例分成3组:多形性腺瘤、腺淋巴瘤、恶性肿瘤.多形性腺瘤31例,全部单发;腺淋巴瘤19例,9例单发,10例多发,共30个病灶;恶性肿瘤12例,3例淋巴瘤多发,其余均为单发,共18个病灶.比较分析3种肿瘤的ADC值.结果:多形性腺瘤和腺淋巴瘤多发生于腮腺浅叶(43个,70.5％),肿瘤边界多清楚,体积一般较恶性肿瘤小;恶性肿瘤位于深叶者8个(44.4％),边界清楚或不清楚,多伴有颈部淋巴结肿大(10例,83.3％).多形性腺瘤及恶性肿瘤平均ADC值均高于腺淋巴瘤(P=0.000、0.002),且多形性腺瘤平均ADC值高于恶性肿瘤(P=0.001).结论:腮腺肿瘤的常规MRI征象具有一定特点,联合DWI能为腮腺常见肿瘤的诊断及鉴别诊断提供更多依据.     

判别函数在腮腺肿瘤CT诊断中的价值

目的：分析腮腺肿瘤的CT表现特征,探讨判别函数在腮腺良恶性肿瘤诊断中的价值。方法：回顾性分析85例经病理证实的腮腺肿瘤病例资料。对良、恶性肿瘤组间的性别、部位、边界、平扫密度及颈部淋巴结肿大等指标行χ^2检验;对年龄、横断面最大径及CT增强幅值等指标行两独立样本t检验。根据肿瘤最大径、边界、CT增强幅值及颈部淋巴结肿大等指标建立判别函数。结果：良恶性肿瘤间患者年龄、平扫边界、横断面最大径、增强幅值及颈部淋巴结等指标的差异有统计学意义;而性别和肿瘤发生部位的差异无统计学意义。通过建立判别函数,对良、恶性肿瘤的判别符合率分别为93.8%和90.0%,整体的判别符合率为92.9%。结论：以肿瘤边界、横断面最大径、增强幅值及颈部淋巴结等四项指标建立判别函数对良、恶性腮腺肿瘤的鉴别能力强。     

CT在腮腺肿块性病变的诊断与鉴别诊断中的价值

目的:探讨CT对腮腺肿块性病变的诊断与鉴别诊断价值,提高术前定性诊断准确性。方法:回顾性分析经手术病理证实的52例原发性腮腺肿块性病变,所有病例均行平扫,其中39例行CT增强扫描,将CT诊断结果与病理结果进行对照研究。结果:35例良性肿瘤CT表现为圆形或类圆形边界清楚肿块22例,浅分叶13例,多形性腺瘤病灶内密度较均匀,腺淋巴瘤(6/9)易出现囊性变;14例恶性肿瘤CT表现为分叶状或不规则肿块影,边界毛糙模糊,其内密度欠均匀,发生坏死囊变(7/14),与邻近咬肌及胸锁乳突肌分界欠清楚(8/14);3例嗜酸性淋巴肉芽肿CT表现为单侧或双侧腮腺浅叶弥漫性增大,并颌下和颈部淋巴结大。CT均能对52例腮腺肿瘤准确定位,多数病变CT能准确定性,但对低度恶性肿瘤与良性肿瘤,囊变淋巴瘤与淋巴上皮癌,深叶嗜酸性腺瘤与恶性肿瘤难以鉴别。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,CT对大多数腮腺良、恶性肿瘤能做出正确诊断。     

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。     

Basal cell adenoma versus pleomorphic adenoma of the parotid gland: CT findings

OBJECTIVE: Basal cell adenoma is a rare benign epithelial tumor of the salivary gland. The objective of this study is to present the CT findings of parotid basal cell adenoma. We also compare CT findings of basal cell adenoma with those of pleomorphic adenoma, the most common parotid tumor, to determine whether any features on CT can help differentiate these two entities. CONCLUSION: Basal cell adenomas of the parotid gland are located chiefly in the superficial lobe. They are generally round, well-circumscribed tumors that show heterogeneous enhancement on CT. The age of the patient and the attenuation on unenhanced and contrast-enhanced CT may help in differentiating basal cell adenoma from pleomorphic adenoma of the parotid gland.     

Dynamic multislice computed tomography findings for parotid gland tumors

OBJECTIVE: Our aim was to research the enhancement features of parotid gland masses in detail and characterize if the masses were Warthin tumors, adenomas, or malignant tumors. METHODS: The prospective study included 25 parotid tumors in 21 patients. Neck computed tomography (CT) was performed using a multislice CT unit. A full-neck CT examination was done at 30 seconds after completion of contrast injection, and then tumor-level images were obtained at 90 seconds and at 5 and 25 minutes. Computed tomography number (lesion density in Hounsfield units) was determined at each phase, and differences within and among tumor groups were statistically analyzed. Diagnoses were confirmed by histopathology. RESULTS: There were 11 Warthin tumors, 8 pleomorphic adenomas, 5 malignant tumors, and 1 basal cell adenoma. Ten Warthin tumors showed rapid contrast enhancement at 30 seconds and rapid reduction of enhancement from the first to the fourth phase. The basal cell adenoma showed also a peak enhancement at 30 seconds. Seven pleomorphic adenomas showed increased enhancement through the first 3 phases. Four malignant tumors showed peak enhancement at 90 seconds. Statistically significant differences within and among tumor groups were determined. CONCLUSIONS: The data suggest that peak tumor enhancement at 30 and 90 seconds, respectively, might identify Warthin and malignant tumors. Increased enhancement through all phases might be an indicator for diagnosing pleomorphic adenomas.     

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。     

常规MRI联合DWI在腮腺常见肿瘤中的诊断价值

目的:探讨常规MRI联合DWI对腮腺常见肿瘤的诊断价值。方法:回顾性分析经病理证实的62例腮腺肿瘤的MRI图像,根据其DWI图行ADC图重建,测量肿瘤的ADC值。按发病率将62例病例分成3组:多形性腺瘤、腺淋巴瘤、恶性肿瘤。多形性腺瘤31例,全部单发;腺淋巴瘤19例,9例单发,10例多发,共30个病灶;恶性肿瘤12例,3例淋巴瘤多发,其余均为单发,共18个病灶。比较分析3种肿瘤的ADC值。结果:多形性腺瘤和腺淋巴瘤多发生于腮腺浅叶(43个,70.5%),肿瘤边界多清楚,体积一般较恶性肿瘤小;恶性肿瘤位于深叶者8个(44.4%),边界清楚或不清楚,多伴有颈部淋巴结肿大(10例,83.3%)。多形性腺瘤及恶性肿瘤平均ADC值均高于腺淋巴瘤(P=0.000、0.002),且多形性腺瘤平均ADC值高于恶性肿瘤(P=0.001)。结论:腮腺肿瘤的常规MRI征象具有一定特点,联合DWI能为腮腺常见肿瘤的诊断及鉴别诊断提供更多依据。     

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。     

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.     

颌下腺混合瘤的CT表现

目的：总结分析颌下腺混合瘤的CT表现。方法：回顾性分析13例经手术病理证实的颌下腺混合瘤的CT表现,所有病例均行轴面平扫和增强扫描,并与病理结果进行对比分析。结果：所有病例均为单侧单发病灶。平扫7例密度低于正常腺体,4例呈等密度,2例密度不均匀,病灶与正常腺体分界不清,13例患侧腺体均增大,肿瘤均未突出腺体包膜,与周围组织的脂肪间隙仍存在;增强扫描病灶强化程度均低于正常腺体,表现为轻至中度强化,3例病灶内出现大小不等圆形低密度影。病灶直径1.4-3.2 cm。结论：颌下腺混合瘤CT表现具有良性肿瘤的特点,结合临床病史,CT可做出正确诊断。