腮腺结核的CT表现和病理分析

目的总结腮腺结核的CT特点,旨在提高对该病的认识和术前诊断水平。方法回顾性分析经手术病理证实的26例腮腺结核的CT特点,并与病理结果对照。结果 (1)病灶部位:23例为单侧,3例为双侧。1例弥漫性病灶,10例为单发病灶,15例为多发病灶;累及浅叶8例,同时累及浅叶和深叶18例。(2)病灶的数量和形态:共56个病灶,10个单发病灶中结节型6个、肿块型4个;45个多发病灶结节型32个、肿块型13个。(3)病灶的密度和强化方式:均未见钙化灶,18例病灶密度均匀,8例病灶密度不均匀。均匀强化病灶6例,环形强化病灶19例,弥漫性强化1例。(4)周围皮肤改变及颈部淋巴结情况:18例出现腮腺周围皮肤增厚。23例患者只有同侧颈动脉鞘周围肿大,3例肺结核患者表现为双侧颈动脉鞘周围淋巴结肿大。结论腮腺结核的CT表现多样性,与其病理表现密切相关,正确认识在腮腺结核CT特点有助于鉴别诊断,但最终诊断仍依赖于病理检查结果。

CT Characteristics and Pathological Analysis of Tuberculosis in Parotid Gland

Objective To summarize the CT characteristics of tuberculosis in parotid gland, improving diagnostic accuracy of this disease.Methods 26 patients with tuberculosis in parotid confirmed by surgical pathology were analyzed retrospectively. All patients underwent preoperative CT plain scan and enhanced scan, comparing with the pathological results.Results (1) Location of the lesions: 23 cases were in one parotid gland and three cases were in both parotid glands. One case was diffuse lesion, 10 cases were single lesions, and 15 cases were multiple lesions. Eight cases involved the shallow lobes of parotid gland, 18 cases involved both the shallow and deep lobes. (2) Amount and morphology of lesions: A total of 56 lesions were found. Six lesions were nodular type and four were tumor type in 10 single lesions; 45 multiple lesions concluded 32 nodular type and 13 tumor type. (3) Density and enhancement forms of the lesions: Focal calcification was not found in all lesions. On CT plain scan, 18 cases showed homogeneous density, and eight cases were inhomogeneous density. On CT enhanced scan, moderate homogeneous enhancement was seen in six cases, ring enhancement was seen in 19 cases, diffuse enhancement was seen in one case. (4) Change of adjacent skin and lymph modes in neck: Thickening of skin around the parotid gland were found in 18 cases. Ipsilateral lmphadenectasis were found in carotid sheath, posterior triangle of the neck and sub maxillary region in 23 patients, bilateral lmphadenectasis were seen in three cases. Conclusion CT characteristics of tuberculosis presents diversity in parotid gland, relating pathological manifestation closely. Correct understanding characteristic CT performance of tuberculosis presents diversity in parotid gland is helpful for differential diagnosis, but final diagnosis still depend on laboratory results and pathological examination.