多层螺旋CT在腮腺良性肿瘤中的诊断价值(附84例分析)

目的回顾分析84例经病理证实的腮腺良性肿瘤MSCT扫描影像特征,探讨MSCT在腮腺良性肿瘤中的诊断价值。方法搜集84例经手术病理证实的腮腺良性肿瘤的MSCT检查资料,所有病例术前均进行CT平扫和双期增强扫描。影像评价:病灶数目、位置,密度、双期增强程度和方式;静脉期与动脉期相比,增强动态变化程度:增高、无变化、减低和混合型,双期增强方式:均匀、不均匀,是否存在不强化的囊变坏死区。结果单发混合瘤40例;腺淋巴瘤29例(6例多发,2例为双侧多发病灶);基底细胞瘤10例(1例为单侧两个病灶);肌上皮瘤5例。肿瘤平扫都表现为大小约1~5cm的边界清楚的软组织密度肿块,部分病例有囊变。增强方式显著不同:腮腺混合瘤动脉期无强化或轻度强化,静脉期呈轻度强化,较动脉期略明显,CT值约升高20Hu;腮腺腺淋巴瘤绝大多数病灶位于浅叶后下极,动脉期显著强化,静脉期呈轻度强化,较动脉期明显减低;腮腺基底细胞瘤动脉期和静脉期均有较显著强化,两者无显著差别,CT值约升高40Hu;腮腺肌上皮瘤动脉期和静脉期均有轻度强化,两者无显著差别,CT值约升高20Hu。结论不同类型的腮腺良性肿瘤的CT平扫和增强表现具有一定的特征性,CT增强检查对于肿瘤的定性诊断有更大帮助。

Value of MSCT in diagnosis of parotid benign tumor: analysis of 84 cases

Objective To analyse the clinical and imaging characteristics in parotid gland benign tumors. Methods The clinical and imaging characteristics of 84 cases of primary parotid benign tumors were analyzed respectively. MSCT plain-scan and enhanced-scan were performed in all the cases. Results In all the 84 cases, 40 cases were solitary mixed tumors, 29 cases were adenolyphomas (in which, 6 cases were multiple tumors, 2 cases were bilateral tumors), 10 cases were basal cell tumors (in which, one case had two small tumors), 5 cases were myoepthelioma. The diameter was 1-5 cm in most of cases, which margin was smooth and clear, cystic changes in some cases. Mixed tumor has no or slight enhancement in the arterial phase, slight enhancement in the venous phase; adenolyphomas had significant enhancement in the arterial phase, slight enhancement in the venous phase, basal cell tumor had significant enhancement in the arterial and venous phase, myoepthelioma had slight enhancement in the arterial and venous phase. Conclusion MSCT is helpful to differentiate diverse parotid benign tumors; particularly the features of different tumors in enhanced CT are typical and characteristic.