MSCT双期增强扫描结合彩超对腮腺肿瘤的诊断价值  

Enhanced Dual-phase Multi-slice Spiral CT Combined with Color Doppler in Diagnosis of Parotid Tumors

作　　者：贺芬宜[1] 苏丹柯[1] 刘丽东[1] 金观桥[1] 谢东[1] 李强[1] 

机构地区：[1]广西医科大学附属肿瘤医院影像诊断中心,广西南宁530021

出　　处：《实用放射学杂志》2011年第5期678-681,810,共5页Journal of Practical Radiology

摘　　要：目的 研究多层螺旋CT（MSCT）双期增强扫描结合彩色多普勒血流显像（CDFI）对腮腺良恶性肿瘤的诊断价值.方法 分析手术病理证实的腮腺多形性腺瘤12例、腺淋巴瘤10例、缺乏恶性形态学CT表现特征的恶性肿瘤13例的术前MSCT双期增强扫描和CDFI影像资料,研究CT对腮腺肿瘤的诊断价值和限度以及CDFI诊断恶性肿瘤的阻力指数（RI）阈值,评价2种影像学手段相结合的诊断价值.结果 ①腺淋巴瘤与恶性肿瘤和良性多形性腺瘤的双期增强CT值均存在显著统计学差 异（P＜0.05）,而后二者CT值差异无统计学意义（P＞0.05）;②MSCT双期增强扫描对腺淋巴瘤的定性诊断敏感度和特异度极高（分别为90%和100%）,对良性多形性腺瘤和恶性肿瘤的定性诊断敏感度、特异度较低（分别为60.00%、65.21%和46.15%、59.10%）;以RI≥0.77作为CDFI诊断恶性肿瘤的阈值标准,诊断敏感度和特异度分别为92.30%、83.33%; ③采用MSCT双期增强扫描结合CDFI对恶性肿瘤的鉴别诊断敏感度、特异度分别为84.62%、100%.结论 MSCT双期增强扫描结合CDFI能弥补前者的不足,明显提高缺乏恶性形态学CT表现特征的腮腺恶性肿瘤的诊断准确度.Objective To investigate the diagnostic value of dual-phase enhanced multi-slice spiral CT（ MSCT） combined with color Doppler flow imaging（CDFI） for the benign and malignant tumors of parotid gland. Methods The imaging data of dual-phase enhanced MSCT and CDFI in 12 cases with benign pleomorphic adenoma, 10 cases with Warthin＇ s tumor and 13 cases with lack of morphological characteristic features of malignant tumors confirmed by pathology were analysed. The diagnostic value and limitation of dual-phase enhanced MSCT in the parotid tumors, and the threshold values of resistanee index（ RI） CDFI in diagnostic malignant tumors were evaluated. Results ①The CT attenuation value at enhanced dual-phase in Warthin＇s tumors was diffirentfrom that in malignant tumor and benign pleomorphic adenoma（P〈0.05} , but there were no statistical differences between malignant tumor and benign pleomorphic adenoma（ P〉0.05）. ②The sensitivity and the specificity were 90% and 100Y0 respectively in diagnosis of Warthin＇s tumor,60.00%,65.21% and 46.15%,59.10% respectively in pleomophic adenomas and malignant tumor. Taking into consideration of RI≥0.77 as the threshold for diagnosis of malignant tumor of the parotid gland,the sensitivity and the specificity in diagnosis of malignant tumor were 92.30% and 83.33%, respectively. ③The sensitivity and the specificity in diagnosis of malignat tumor were 84.62 % and 100 % respectively by enhanced dual-phase MSCT in combination with the CDFI. Conclusion Contrast-enhanced dual-phase MSCT in combination with CDFI examination can improve the diagnostic accuracy of parotid malignant tumors which are subsequently lack of morphological characteristics.

关 键 词：腮腺 肿瘤 体层摄影术 X线计算机 彩色多普勒血流显像 

分 类 号：R739.8[医药卫生—肿瘤] R814.42[医药卫生—临床医学]