腮腺多形性腺瘤与腺淋巴瘤的CT特征及鉴别诊断

目的探讨腮腺多形性腺瘤与腺淋巴瘤的CT特征及鉴别诊断。方法选取2017年3月12日至2020年2月18日收治的65例疑似腮腺多形性腺瘤患者,设为多形性腺瘤组;选取同期65例疑似腺淋巴瘤患者,设为腺淋巴瘤组。两组患者均进行CT检查及病理活检检查。以病理检查结果为金标准,分析CT检查对腮腺多形性腺瘤、腺淋巴瘤的诊断价值,比较两组患者的CT影像学特征、静脉期强化幅度、动脉期强化幅度、平扫CT值。结果CT诊断腮腺多形性腺瘤的灵敏度、特异度、漏诊率、误诊率分别为96.23%、91.67%、3.77%、8.33%。CT诊断腺淋巴瘤的灵敏度、特异度、漏诊率、误诊率分别为96.30%、90.91%、3.70%、9.09%。两组的部位、扫描强化程度比较,差异具有统计学意义(P<0.05)。多形性腺瘤组的静脉期强化幅度、动脉期强化幅度、平扫CT值均低于腺淋巴瘤组(P<0.05)。结论腮腺多形性腺瘤和腺淋巴瘤虽具有较多相似特征、影像特点,但也有各自较为明显、典型的CT影像特征,临床需结合CT检查综合考虑。

CT features and differential diagnosis of pleomorphic adenoma of parotid gland and adenolymphoma

Objective To explore the CT features and differential diagnosis of pleomorphic adenoma of parotid gland and adenolymphoma.Methods A total of 65 patients with suspected pleomorphic adenoma of parotid gland from March 12,2017 to February 18,2020 were selected as pleomorphic adenoma group;and 65 patients with suspected adenolymphoma in the same period were selected as adenolymphoma group.CT and pathological biopsy were performed in both groups.Taking pathological examination results as the gold standard,the diagnostic value of CT examination for pleomorphic adenoma of parotid gland and adenolymphoma were analyzed.The CT imaging characteristics,enhancement amplitude of venous phase,arterial phase and plain CT value of the two groups were compared.Results The sensitivity,specificity,missed diagnosis rate and misdiagnosis rate of CT in the diagnosis of pleomorphic adenoma of parotid gland were 96.23%,91.67%,3.77%and 8.33%,respectively.The sensitivity,specificity,missed diagnosis rate and misdiagnosis rate of CT in the diagnosis of adenolymphoma were 96.30%,90.91%,3.70%and 9.09%,respectively.There were significant differences in the location and scanning enhancement between the two groups(P<0.05).The enhancement amplitude of venous phase,arterial phase and plain CT value of the pleomorphic adenoma group were lower than those of the adenolymphoma group(P<0.05).Conclusion Although pleomorphic adenoma of parotid gland and adenolymphoma have more similar features and imaging features,they also have their own obvious and typical CT imaging features,which should be considered in combination with CT examination.