腮腺良性肿瘤的CT及彩超检查诊断与病理学对照分析

目的研究多层螺旋CT（MSCT）及彩色多普勒血流显像（CDFI）对腮腺多形性腺瘤和腺淋巴瘤的诊断价值及其病理基础。方法对手术病理证实的12例多形性腺瘤和10例腺淋巴瘤的术前MSCT双期增强扫描及CDFI影像学资料进行病理学对照研究,并评价两种检查手段的诊断价值。结果①MSCT双期增强扫描显示多形性腺瘤呈延迟强化表现、腺淋巴瘤呈延迟排空表现,且二者双期强化程度之间的差异有统计学意义（P〈0.05）。②CDFI显示腺淋巴瘤的血供较多形性腺瘤丰富,二者的血流信号差异有统计学意义（P〈0.05）。③病理上多形性腺瘤组织内黏液样和软骨样组织间质丰富,血管结构稀少;腺淋巴瘤组织内淋巴样间质成分丰富,淋巴间质中和被膜内外均有大量血管分布。④CT延迟强化征象对多形性腺瘤诊断的敏感度、特异度分别为91.67%、90.00%,延迟排空征象对腺淋巴瘤诊断的敏感度、特异度为90.00%、100%;CDFI对二者诊断的敏感度和特异度分别为75.00%、80.00%和80.00%、83.33%。结论腮腺多形性腺瘤和腺淋巴瘤的MSCT及CDFI影像学表现特征均与其肿瘤病理学基础相符;MSCT双期增强扫描较CDFI对二者具有更高的诊断价值。

Comparison of CT and color Doppler diagnosis on parotid benign tumor by pathologic analysis

ObjectiveTo study the diagnosis value of dual-phase enhanced multi-slice spiral CT （MSCT） and color Doppler flow image （CDFI） on diagnosis of parotid pleomorphic adenoma.MethodsTwelve cases of pathologically confirmed parotid pleomorphic adenoma and 10 cases of adenolymphomas were undergone MSCD and CDFI examinations respectively.ResultsBy MSCT,pleomorphic adenoma showed delayed enhancement while adenolymphoma showed washout,their degree of enhancement were statistically different （P〈0.05）.Blood supply in adenolymphoma was richer than that in pleomorphic adenoma by CDFI,and the difference was statistically significant （P〈0.05）.Pleomorphic adenoma showed rich cartilage,myxoid stroma and rare vascular structure,while adenolymphoma showed rich lymphoid stroma and large number of blood vascular.The sensitivity and specificity of MSCT on diagnosing pleomorphic adenoma were 91.67% and 90.00% respectively,on adenolymphoma were 90.00% and 100% respectively.While the sensitivity and specificity of CDFI on diagnosing pleomorphic adenoma were 75.00% and 80.00% respectively,on adenolymphoma were 80.00% and 83.33% respectively.ConclusionsThe imaging features of parotid pleomorphic adenoma and adenolymphoma by MSCT and CDFI are consistent with tumors＇ pathologic features.The diagnostic value of MSCT is better than that of CDFI.