腮腺区常见占位性病变的CT鉴别诊断

目的：评估CT对腮腺区占位性病变的诊断及鉴别诊断价值。方法：回顾性分析51例腮腺区占位性病变，所有病例均行CT平扫及增强扫描，且均有手术病理证实，将CT诊断与病理结果进行对照研究。结果：腮腺区良性占位38例,恶性13例。CT扫描良性病变常表现为形态规则边界清晰的肿块，以多形性腺瘤（18／38）居多，平扫其内部密度较均匀；其次为腺淋巴瘤（10／38），常位于腮腺后下极（9／10）并易囊变液化（2／10）；13例腮腺区恶性占位性病变中原发性恶性肿瘤7例，CT常表现为形态不规则，边界不清晰，以粘液表皮样癌居多（5／7）。转移瘤6例，以鼻咽部来源常见（5／6），常可见肿大淋巴结及原发灶。结论：CT扫描对腮腺浅叶病变定位定性较为准确，对于腮腺深叶病变及并发感染病变的定位及定性有一定困难。

Differential diagnosis of space occupying lesions in parotid gland with CT

Objective： To evaluate the value of CT in the diagnosis and differential diagnosis of parotid gland space occupied lesions. Methods： Fifty-one patients with proved parotid occupying lesions were analyzed retrospectively. All patients were scanned with plain CT and contrast CT. Results： There were 38 benign masses and 13 malignant lesions. Benign lesions demonstrated regular shape and clear margin. Among the 38 benign lesions pleomorphic adenomas （18138） are most common, which were often found in the superficial lobe, with homogenous density; followed by adenolymphoma （10/38）, which were often found in the posterior-inferior part of the parotid gland（9/10）. There were 7 primary malignant lesions among the 13 malignant masses, which were often showed as irregular masses with unclear margin. The most common primary malignant lesions were mucoepidermoid carcinoma （5/7）. Metastatic tumors often came from nasopharynx （5/6）, which was easy to find enlarged lymph nodes and primary leisons. Conclusions： CT is sensitive in detecting and diagnosing the occupying lesions of the shallow lobe of parotid gland, it was not good enough to detect or diagnose the occupying lesions of the deep lobe and lesions with infection.