腮腺淋巴结结核的CT表现  

CT findings of tuberculous lymphadeultis in parotid gland

作　　者：王长福[1] 邹翎[2] 王斌杰[1] 张和平[1] 靳海英[1] 聂鹏[1] 常亮[1] 魏海港[1] 

机构地区：[1]河南大学淮河医院放射科,开封475000 [2]四川大学华西医院放射科

出　　处：《中华放射学杂志》2008年第11期1175-1178,共4页Chinese Journal of Radiology

摘　　要：目的分析腮腺淋巴结结核的cT表现，以期提高对该病的诊断正确性。方法回顾性分析经手术病理和实验室检查诊断的腮腺淋巴结结核9例，术前均经CT平扫及增强扫描，复习cT扫描结果并与手术病理对照。结果9例中发生于左侧7例，右侧2例。8例位于腮腺浅叶，1例累及腮腺深叶。病灶呈肿块型8例，数目1—4个，直径2．7～5．3cm。浸润型1例，直径3．4cm。CT平扫病灶5例密度均匀，边缘光整，4例病灶内呈斑片状低密度影，其中2例边缘模糊。增强扫描病灶呈中等度均匀强化3例，环形强化4例，不均匀强化1例，花边状强化1例。病灶向周围浸润6例。同侧颈部出现增大淋巴结2例。结论腮腺淋巴结结核的CT表现多样化，与其病理改变密切相关，认识腮腺淋巴结结核的特征性CT表现有助于鉴别诊断，确诊仍依靠病理及实验室检查。Objective To analyze the CT findings of tuberculous lymphadenitis in parotid gland, so as to improve the diagnostic accuracy of tuberculosis of parotid gland. Methods Nine cases with tuberculous lymphadenitis in parotid gland confirmed by surgical pathology and acid-fast bacilli after preoperative spiral CT plain scan and two phases dynamic enhancement scan were retrospectively analyzed. Imaging findings of CT were reviewed and compared with surgical pathology. Results Seven of the 9 cases of tuberculosis of the parotid gland occurred in the left side, and 2 in the fight side, and superficial lobe involvement occurred in 8 cases and deep lobe in 1 case. The lesion was classified as tumour type （8 cases） and infiltration type （1 case）. In tumour type, the number of lesion was from 1 to 4, and the size was from 2. 7 to 5.3 cm in diameter. One case of infiltration type measured 3.4 cm in diameter. On CT plain scan, the lesions showed homogeneous slight high-density with regular edge in 5 cases and irregular low-density in 4 cases, and 2 of them with partly blurred edge. On CT enhanced scan, uniform moderate enhancement was seen in 3 cases, circular enhancement in 4 cases, inhomogeneous enhancement in 1 case, and lace-like enhancement in 1 case. Local infiltration occurred in 6 cases. Lymphadenovarix in the same side of lesion occurred in 2 cases. Conclusion CT findings of tuberculous lymphadenitis in parotid gland present diversification, which correlate well with pathological changes. Understanding of characteristic CT findings of tuberculous lymphadenitis in parotid gland is helpful for differential diagnosis, but final diagnosis still depends on pathology and acid-fast bacilli.

关 键 词：腮腺疾病 结核 淋巴结 体层摄影术 X线计算机 

分 类 号：R686[医药卫生—骨科学]