腮腺基底细胞腺瘤的CT诊断与鉴别(附6例报道)

目的探讨腮腺基底细胞腺瘤的CT特征。方法回顾分析6例经手术及病理证实的腮腺基底细胞腺瘤的CT图像,重点评价肿瘤的部位、大小、形态、边缘、密度及强化特征。结果 6例均为单发肿块,4例位于腮腺深叶,2例位于浅叶;6个肿瘤均呈圆形,无分叶,边界清晰;肿瘤内部均可见囊变区,其中2例表现为大囊伴壁结节。增强扫描动脉期,肿块实性部分呈显著强化,静脉期密度略有下降。结论腮腺浅叶孤立性结节,边界清晰,内见坏死囊变或呈大囊+壁结节,动脉期实性部分显著强化,静脉期CT值略有下降,应考虑腮腺BCA的可能。     

腮腺基底细胞腺瘤的CT诊断价值

目的:探讨腮腺基底细胞腺瘤的CT表现特征。方法:回顾性分析经手术和病理证实的9例腮腺基底细胞腺瘤的临床和CT检查资料。结果:9例均为单发肿瘤,位于腮腺浅叶,紧邻包膜下。CT平扫肿瘤呈类圆形7例,长椭圆形伴浅分叶2例,边缘清晰,直径多<3cm,4例肿瘤内见囊变;CT增强扫描实质部分动脉期呈显著强化,静脉期强化程度接近或稍低于动脉期,密度相对较均匀。结论:腮腺基底细胞腺瘤的CT表现具有一定的特征性,结合其临床特点有助于其术前定性诊断。     

腮腺基底细胞腺瘤CT和MRI特点

目的 探讨腮腺基底细胞腺瘤的临床特点及CT、MRI影像特征.资料与方法 回顾性分析经手术病理证实的37例腮腺基底细胞腺瘤的CT、MRI影像特点,37例术前均行CT和MR平扫+增强扫描,对患者性别、发病年龄、临床表现、发病部位,以及肿块大小、数目、CT密度、MRI信号强度及强化方式等进行分析.结果 中老年女性多见,多表现为腮腺无痛性肿块.37例病变均位于腮腺浅叶.CT和MRI平扫示肿瘤呈类圆形,无分叶,边缘光滑肿瘤.病变较小,直径为7～30mm;密度、信号欠均匀,21例(56.8％)发生囊变.CT和MRI增强扫描示37例有较显著强化.结论 腮腺基底细胞腺瘤具有体积小、易囊变、强化显著等影像学特征,结合临床特点对于肿瘤的定性诊断有很大帮助.     

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。     

腮腺少见肿瘤的影像学特点分析

目的探讨腮腺少见肿瘤的影像学特点。方法回顾性分析13例经手术病理证实腮腺少见肿瘤(淋巴上皮癌4例,肌上皮瘤3例,淋巴瘤及转移瘤各2例,恶性黑色素瘤及肌上皮癌各1例)的CT、MRI影像学表现。结果均为腮腺单侧发病,其中左侧9例,右侧6例。淋巴上皮癌位于腮腺浅叶,可累及深叶,以单发为主(3/4);沿腮腺浅叶铸形生长(3/4)可能具有一定特点;密度和信号均匀,增强轻、中度均匀强化。肌上皮瘤均为单发,位于腮腺浅叶,呈椭圆形,边缘清晰锐利,密度和信号均匀或不均匀,显著强化(2/3)可能具有提示作用。淋巴瘤具有一定特点,常表现为多发类圆形肿块(2/2),边缘光整,密度均匀,增强后中度强化,常伴颈部淋巴结肿大。恶性黑色素瘤MRI具有一定特点:T1WI呈多发结节状高信号,T2WI呈低信号;CT及MRI增强不具特点。肌上皮癌与腮腺常见恶性肿瘤相仿。转移瘤表现与原发肿瘤密切相关。结论腮腺上述少见肿瘤部分具有一定影像学特点,有助于鉴别诊断,确诊仍依靠组织病理学和免疫组化。     

腮腺基底细胞腺瘤的CT 诊断

目的：探讨腮腺基底细胞腺瘤的CT特点,提高对腮腺基底细胞腺瘤的术前诊断准确率。方法回顾性分析经手术病理证实的12例腮腺基底细胞腺瘤的C T影像特点,包括数目、部位、大小、边缘、形态、密度、强化特征。12例患者中男性2例,女性10例,年龄26～78岁,中位年龄53岁。结果12例患者均为单发肿瘤,10例位于腮腺浅叶,2例累及腮腺深叶及浅叶,肿瘤最长径平均为2．3cm。5例为类圆形,7例为长椭圆形,其中3例有浅分叶。所有病例边缘均光滑清楚。12例中有3例病灶呈实性并有明显强化,9例病灶可见囊变,其中囊变均匀者3例,囊变不均匀者6例,增强扫描后肿瘤实性部分均呈明显强化,CT值平均增加58．2HU。结论腮腺基底细胞腺瘤是一种相对少见的腮腺良性肿瘤,好发于中老年女性,CT表现为腮腺浅叶内边界清晰、边缘光整的实性或囊实性病灶,并且实性成分明显强化,最终确诊需依靠病理学。     

腮腺基底细胞腺瘤的MR特点

目的 初步探讨腮腺基底细胞腺瘤的MR特征,提高对腮腺基底细胞腺瘤的术前诊断准确率.方法 回顾性分析4例经手术病理证实的腮腺基底细胞腺瘤的MR影像特点,包括数目、部位、大小、形态、边缘、信号特点、强化特征以及颈部间隙淋巴结情况.结果 男性3例(75％),女性1例(25％),平均年龄47岁(37～55岁).4例均为单发肿瘤,其中左侧1例,右侧3例.除1例累及腮腺深叶及浅叶外,其余肿瘤均位于腮腺浅叶.肿瘤平均大小约为1.98 cm×1.48cm.1例肿瘤呈哑铃形,3例肿瘤呈类圆形.肿瘤轮廓清晰,并有包膜形成.以腮腺为标准:2例肿瘤信号均匀,T1WI呈低信号,化学位移选择饱和法(CHESS)脂肪抑制T2WI呈高信号,FSE T2WI呈低信号.1例肿瘤T1WI及T2WI均呈高低混杂信号,内有血肿信号.1例肿瘤T1WI呈低信号,脂肪抑制T2WI呈略高信号,FSE T2WI呈略低信号,周围可见小裂隙样囊变.增强扫描,所有肿瘤实质成分明显强化.1例肿瘤同侧颈血管间隙多个淋巴结肿大,但信号均匀.结论 中老年患者腮腺浅叶内单侧单发轮廓清晰,边缘光整病变,实性或囊实性伴有出血,显示低信号包膜,并且实性成分明显强化,提示腮腺基底细胞腺瘤的可能.     

脾脏占位病变的CT和MRI表现

目的 分析脾脏占位病变（SSOL）的CT和MRI表现,提高对本病的认识和影像诊断水平。资料与方法 回顾性分析2013年4月—2020年12月遵义医科大学附属医院经病理证实的42例SSOL的CT和MRI表现,包括病灶大小、形态、密度/信号、强化方式等。其中33例行CT检查,8例行CT及MRI检查,1例行MRI检查。结果 42例SSOL中,非肿瘤性病变15例（囊肿6例、结核6例、戈谢病2例、隐球菌病1例）,良性肿瘤18例（脉管瘤13例、窦岸细胞血管瘤3例、硬化性血管瘤样结节转换2例）;恶性肿瘤（淋巴瘤）9例。囊肿CT表现多呈单发无强化囊性病灶。结核CT和MRI表现多样。戈谢病CT表现为多发低密度结节,中度强化。隐球菌病CT表现为脾脏增大并增强扫描多发结节、肿块。脉管瘤CT表现为单发或多发囊性病灶,强化方式多样;MRI表现为T1WI低信号,T2WI高信号结节,强化与CT相似。窦岸细胞瘤CT表现为低密度结节,轻度渐进性强化或明显强化;MRI表现为T1WI、T2WI等信号结节,扩散加权成像呈高信号。硬化性血管瘤样结节转换CT表现为单发低密度结节,不均匀强化;MRI表现为T1WI等、稍低信号,T2...     

腮腺黏液表皮样癌的CT和MRI表现

目的:探讨腮腺黏液表皮样癌(MEC)的CT和MRI表现,提高其诊断准确率.方法:回顾性分析经手术病理证实的9例腮腺MEC的CT和MRI资料,分析腮腺肿块大小、形态、边界、密度、信号、强化模式、周围结构侵犯及颈部淋巴结情况.结果:9例病灶均为单发,5例累及腮腺浅深两叶,1例位于腮腺深叶,3例位于腮腺浅叶.3例行CT检查,...     

腮腺上皮组织良性肿瘤的临床及CT、MRI特点分析

目的回顾性分析腮腺上皮类良性肿瘤的影像学征象,寻求鉴别诊断要点。方法回顾性分析发生在腮腺内经手术及病理证实为腮腺上皮组织来源良性肿瘤的42例患者的临床及CT或MRI资料。结果 42例患者中,腮腺浅叶34例,位于深叶8例,其中多形性腺瘤21例(均为单发);腺淋巴瘤13例,其中6例为多发(4例为一侧多发,2例为双侧病灶);5例为基底细胞腺瘤(均单发);肌上皮瘤2例,均单发;本组病例中多形性腺瘤多见于中老年女性,CT或MRI上病变大多界清、光整,可有浅分叶及囊变,增强扫描肿瘤表现为持续渐进性强化;本组患者腺淋巴瘤大多有长期吸烟史,以中老年男性患者居多,病灶单发或多发、单侧或双侧,腮腺浅叶为其好发部位,增强后多表现为"快进快出",可见"血管贴边征";基底细胞腺瘤本组主要见于中青年女性,以腮腺浅叶居多,位于深叶者肿瘤体积偏大,肿瘤极易于囊变,增强后实性部分明显持续强化,典型者可见"裂隙"样表现;肌上皮瘤本组两例均发生于老年患者,腮腺浅叶,肿瘤形态欠规则,内见坏死囊变,增强后实性部分明显强化。结论 CT或MRI增强扫描对于腮腺组织上皮来源大部良性肿瘤的鉴别及定性诊断具有重要的价值,结合发病年龄、性别及部位可作出有效的鉴别诊断。     

腮腺腺淋巴瘤磁共振成像的影像学表现

目的探讨腮腺腺淋巴瘤(Warthin瘤)的磁共振成像(MRI)影像学表现,以提高术前诊断准确性。方法对手术病理证实的29例腮腺腺淋巴瘤的术前MRI图像进行回顾性分析。其中,男性27例,女性2例。年龄42~85岁,平均(62±8)岁。结果 29例腮腺腺淋巴瘤患者中共发现54个肿瘤(单侧单发20例,单侧多发4例,双侧多发5例),其中36个(67%)位于腮腺浅叶和中下极,无单独发生于深叶的病灶。肿瘤一般呈类圆形、椭圆形或浅分叶状软组织结节或肿块,边缘光整、大部分可见包膜(50个),病灶小者信号较均匀、较大者信号混杂,T1WI大部分低信号,T2WI及压脂T2WI高低混杂信号、灶周及部分病灶内见留空血管影,增强后实质成分表现为较明显强化,且大部分早期强化、延时期减退。其中19例可见囊变,囊变区呈类圆形液性信号影,囊变区呈明显的T1WI低信号T2WI高信号。结论腮腺腺淋巴瘤有一定的临床和影像特点,根据其发病年龄、性别、部位及影像学表现,有助于该病的诊断和鉴别诊断。     

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。     

原发性输卵管癌影像学表现

目的：探讨原发性输卵管癌（PFTC）的影像学表现,提高对该病的诊断准确性。方法：回顾性分析12例经手术病理证实的PFTC病例,其中9例行CT检查,3例行MRI检查。结果：10例为单侧病灶,2例为双侧病灶。CT表现：输卵管区分叶状或不规则状实性肿块1例;不规则囊实性肿块5例;腊肠形、“C”形实性肿块3例;管状囊性肿块伴管壁软组织结节3例。增强后实性部分轻到中度强化,呈延时强化,囊性部分不强化。MRI表现：实性部分呈稍长T1稍长T2信号,囊性部分呈长T1长T2信号,增强后肿块不均匀强化,实性部分DWI呈高信号。5例伴有输卵管积水。8例患侧子宫圆韧带均匀增粗,走形自然,增强后均匀强化。结论：PFTC典型表现为附件区腊肠样实性肿块,管形囊性肿块伴乳头状突起,伴输卵管积水。患侧子宫圆韧带增粗是PFTC重要的间接征象。     

Basal cell adenoma in the parotid gland: CT and MR findings

Basal cell adenoma is a rare benign salivary gland epithelial tumor, usually involving the parotid gland. We report CT and MR findings of three cases with basal cell adenoma occurring in the parotid gland. The three cases presented here demonstrate a well-circumscribed tumor, which showed a cystic and solid, or the pure solid mass. They were well enhanced after contrast matter injection. The solid portion of the mass was isoattenuated at CT, with intermediate signal intensity on T1- and T2-weighted MR images. Its cystic portion was hyperintense on both T1- and T2-weighted MR images. It had a hypointense rim on T2-weighted image.     

腮腺腺淋巴瘤的MRI表现

目的探讨MRI对腮腺腺淋巴瘤的表现特征的显示。资料与方法回顾性分析17例经病理证实的腮腺腺淋巴瘤的影像资料。结果 (1)17例腮腺腺淋巴瘤患者中男16例,女1例,50岁以上者13例。9例病灶单发,8例多发,共32个病灶,病灶中心位于腮腺后下象限者18个(56.25%),形态呈类圆形28个(87.5%),分叶4个(12.5%),边缘清楚31个(96.88%),边缘模糊1个。(2)和肌肉相比,病灶在快速自旋回波(FSE)T1WI显示为等、稍高、高信号的数目分别占5/32个(15.625%),25/32个(78.125%),2/32个(6.25%);FSE T2WI及T2WI脂肪抑制序列呈中等高信号,数目分别为17/32个,15/32个;2/32个,30/32个;FSE T1WI信号均匀31/32个,FSET2WI及T2WI脂肪抑制序列信号不均匀者32/32个,小囊变区18/32个(56.25%),32个病灶均显示低信号包膜;(3)增强轻度强化比率31.25%,中度强化31.25%,明显强化37.5%;(4)17例中,误诊为混合瘤4例,2例笼统诊断为良性肿瘤,余11例均正确诊断为腺淋巴瘤。结论中年以上的男性,MRI发现腮腺浅叶的后下象限具有良性肿瘤病灶特征,平扫各序列显示有低信号包膜,在FSE T1WI,FSE T2WI及FSE T2WI脂肪抑制序列信号特征多为稍高/中等高/高信号。采用FSE T2WI脂肪抑制序列观察到内部有小囊变区,强化多为中等或明显强化,且病灶多发时,诊断时应首先考虑腺淋巴瘤可能。     

Complex renal cysts: findings on MR imaging.

OBJECTIVE: We retrospectively evaluated our experience with complex cystic renal masses on MR imaging, using T1-weighted, T2-weighted, and gadolinium-enhanced images, to determine whether imaging features could permit distinction between benign and malignant lesions. MATERIALS AND METHODS: Thirty-seven patients with complex cystic renal lesions were included in this retrospective study. The patients selected had undergone T1-weighted, T2-weighted, and gadolinium-enhanced MR imaging examinations using 1.5-T scanners, with at least one of the following findings: cyst fluid of heterogeneous signal intensity, mural irregularity, septa, mural masses or nodules, increased mural thickness, or intense mural enhancement. The diagnosis was established by histology in 19 patients and by follow-up studies in the remaining 18 patients. RESULTS: Fifty-five complex renal cystic lesions were present in the 37 patients. Among the 55 lesions, of 37 that contained fluid of a heterogeneous signal intensity, eight were malignant (22%); of 16 with irregular walls, 10 were malignant (63%); of four with septa, two were malignant (50%); of four with mural masses or nodules, three were malignant (75%); of 14 with a thick wall (>2 mm), 10 were malignant (71%); and of 32 with intense mural enhancement, 14 were malignant (44%). As independent variables, mural irregularity, mural masses or nodules, increased mural thickness, and intense mural enhancement each were highly associated with malignancy (p = .0003-.0022). The combination of mural irregularity and intense mural enhancement had the highest correlation with malignancy (p = .0002). CONCLUSION: The combination of mural irregularity and intense mural enhancement is a strong predictor of malignancy in renal cystic lesions. However, the appearance of benign and malignant lesions may overlap, suggesting that distinct separation of these entities is not currently possible in all cases with MR imaging.     

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。     

Acinic cell carcinoma of the head and neck: radiologic-pathologic correlation

OBJECTIVE: To describe and correlate the imaging and pathologic findings of acinic cell carcinoma (ACC) in the head and neck. METHODS: We reviewed the radiologic findings of 12 patients with pathologically proven ACC in the head and neck. They were 6 males and 6 females (ages: 5-75 years, mean 36 years) who undergoing computed tomography (CT, n=9) and CT with magnetic resonance (MR) imaging (n=3). RESULTS: The lesions in the superficial lobe of the parotid gland were solid (n=7), cystic (n=1), and cystic mass with mural nodule (n=1) on CT. A parapharyngeal lesion was cystic mass with mural nodule, and a submandibular and a palate tumor were cystic lesions on CT. All solid masses in the parotid gland (n=7) included focal low-attenuating portions on CT, which were microcyst, hemorrhage, or necrosis on pathologic examination. We could not find intratumoral calcifications or metastatic lymphadenopathy on imaging and histologic studies in all 12 cases. Internal hemorrhage on the MR images was seen in a parapharyngeal and a parotid lesion. CONCLUSION: Although ACC appears to have nonspecific imaging findings, familiarity with some imaging features can be helpful for differential diagnosis of head and neck tumors.