腮腺基底细胞腺瘤和多形性腺瘤的双期增强CT的诊断价值

 目的 探讨腮腺基底细胞腺瘤(basal cell adenoma,BAC)与多形性腺瘤(pleomorphic adenoma ,PA)的CT特征及鉴别诊断。方法 回顾性分析首都医科大学大兴教学医院2014-01至2018-06经手术病理证实的腮腺BAC患者14例的CT影像及临床资料,并与同期收集的56例腮腺PA进行对比分析。结果 BAC和PA患者表现为腮腺浅叶内单发、形态规则、边界清楚病灶,部分病灶内可见囊变区,BAC平扫CT值(25.9±7.1)HU,与PA的平扫CT值(31.3±10.1)HU相比,差异无统计学意义;增强扫描表现为持续明显强化,BAC动脉期强化幅度值、静脉期强化幅度值分别为(64.3±48.0)HU、(59.4±17.5)HU,均明显高于PA(23.0±13.9)HU、(36.3±15.4)HU,差异有统计学意义(P<0.01)。结论 腮腺BCA与PA均具有单发、好发浅叶、边界光整、可囊变等特征; CT双期增强扫描有助于两者诊断及鉴别诊断。

The diagnostic value of dual-phase CT enhancement appearances of basal cell adenoma and pleomorphic adenoma in the parotid gland

Objective To explore CT imaging features and differential diagnosis of basal cell adenoma (BCA) and pleomorphic adenoma (PA) in the parotid gland. Methods The clinical data and CT image findings of 14 cases of patients with BCA confirmed by pathology after surgical resection in our hospital between January 2014 and June 2018 were analyzed retrospectively. CT appearances were compared between BCA and (PA) (n=56). Results All the 14 patients had solitary BAC lesions and most of them had solitary PA lesions, which were located in the superficial lobe of the parotid gland. The lesions had a clear boundary and round shape without lobular appearance. Some of the lesions displayed cystic changes. CT plain-scan showed that the CT value (25.9±7.1)HU was not significantly different from that of PA (P>0.05). During dual-phase scan, BCA showed a pattern of persistent enhancement. The net enhancement CT value of the arterial phase and venous phase [(64.3±48.0)HU,(59.4±17.5)HU] was statistically different from that of PA [(23.0±13.9)HU,(36.3±15.4)HU](P<0.01). Conclusions Both BCA and PA of the parotid gland share some clinical and CT imaging features, such as solitary occurrence, location in the superficial lobe, a clear boundary and cystic changes. When dual-phase enhanced scanning is used, BCA and PA behave differently, which can facilitate differential diagnosis.