腮腺恶性肿瘤的MRI诊断价值及其病理基础  

Magnetic resonance imaging for diagnosis of parotid malignant tumors and the pathological basis

作　　者：杜立新[1] 元建鹏[2] 关弘[3] 张卫东[4] 梁碧玲[2] 

机构地区：[1]深圳大学第一附属医院放射科,广东深圳518035 [2]中山大学孙逸仙纪念医院放射科,广东广州510120 [3]深圳大学第一附属医院病理科,广东深圳518035 [4]中山大学附属肿瘤医院放射科,广东广州510060

出　　处：《南方医科大学学报》2010年第5期1107-1110,共4页Journal of Southern Medical University

摘　　要：目的探讨MRI征象在腮腺恶性肿瘤中的诊断价值及其病理基础。方法腮腺恶性肿瘤47例,41例经手术病理证实,6例活检证实。30例获得完整病灶者行病理逐层切片检查并与MRI进行了对照分析。回顾性分析各形态学征象,总结常见腮腺恶性肿瘤的表现。结果 MRI对腮腺恶性肿瘤的定性诊断准确。4例低度恶性粘液表皮样癌边界清楚,与良性肿瘤难区别;6例中、高度恶性者边界不清,易发生坏死及淋巴结转移。8例腺样囊性癌以侵犯范围广泛为特征。8例混合瘤恶变多数在T2WI仍出现高而不均匀信号,且形状不规则,边界不清楚。9例淋巴瘤浸润范围大,可分辨出由多个结节组成。4例腺泡细胞癌内有T1WI和T2WI均为高信号的囊变区,形状规则或不规则。结论 MRI对腮腺恶性肿瘤的诊断具有重要价值。常见腮腺恶性肿瘤MRI表现及病理组织学各有特点,对多数病例进行鉴别诊断是可能的。Objective To investigate magnetic resonance imaging （MRI） features of parotid malignant tumors and study their pathological basis. Methods Forty-seven patients with parotid malignant tumors confirmed by surgery （41 patients） or biopsy （6 patients） were enrolled in this study. A comparative analysis was conducted of the pathological and MRI findings in 30 patients with the entire lesions available. Each of the MRI features was analyzed retrospectively and the typical MRI findings of common parotid malignant tumors were summarized. Results MRI allowed accurate diagnosis of parotid malignant tumors. Four patients with low-grade mucoepidermoid carcinoma showed well-defined tumor margin and were difficult to distinguish from benign tumors. Six patients with high-grade mucoepidermoid carcinoma had obscure margin of the tumor which easily underwent necrosis with liable lymph node involvement. The 8 cases of adenoid cystic carcinoma was characterized by extensive invasion surrounding the parotid gland. Most of 8 cases of malignant pleomorphic adenoma still showed high and heterogeneous signal on T2WI, with irregular shape and poorly defined margin. Nine cases of lymphoma all had secondary lesions characterized by extensive involvement and presence of multiple nodules. The 4 cases of acinic cell carcinoma showed either regular or irregular tumor morphology, presenting with high signal intensity on T1WI and T2WI. Conclusion MRI is an important modality for the diagnosis of parotid malignant tumors. Most of the common parotid malignant tumors have characteristic MRI and pathological features, which make possible their differential diagnosis.

关 键 词：腮腺肿瘤 磁共振成像 诊断 病理学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.87[医药卫生—诊断学]