CT灌注对腮腺肿块定性诊断的临床价值评价  

Evaluation of CT Perfusion in the Diagnosis of Parotid Gland Mass

作　　者：程琦[1] 许实成[1] 房文亮[2] 赵英明[1] 曹东兴[1] 李志来[3] 胡燕明 

机构地区：[1]安徽医科大学附属省立医院影像科,安徽合肥230001 [2]安徽医科大学临床学院,安徽合肥230022 [3]安徽医科大学附属省立医院口腔科,安徽合肥230001 [4]安徽医科大学附属省立医院五官科,安徽合肥230001

出　　处：《中国医学影像学杂志》2011年第10期721-725,共5页Chinese Journal of Medical Imaging

基　　金：安徽省卫生厅临床医学应用技术项目研究课题(编号:2008B038)

摘　　要：目的探讨多层螺旋CT灌注技术对腮腺肿块定性诊断的价值。资料与方法经术后病理证实的47例患者共50个腮腺肿块,其中良性肿瘤25例(27个肿块),恶性肿瘤8例(8个肿块),炎症肿块14例(15个肿块)。术前均行CT灌注检查,观察并比较不同性质腮腺肿块的血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)、增强峰值(PH)、达峰时间(TTP)及时间-密度曲线(TDC)。结果腮腺良性肿瘤(不包括腺淋巴瘤)的CT灌注参数BF、BV、PH较恶性肿瘤低,差异有统计学意义(P<0.01);TTP较恶性肿瘤长,差异有统计学意义(P<0.01);MTT及PS较恶性肿瘤的差异无统计学意义(P>0.05)。炎性肿块BV较恶性肿瘤低,差异有统计学意义(P<0.01);TTP较恶性肿瘤长,差异有统计学意义(P<0.01);腺淋巴瘤与其他良性肿瘤、恶性肿瘤的TDC形态有显著差异。结论 CT灌注检查对腮腺肿块的定性诊断具有一定的价值。Purpose To explore the value of spiral CT perfusion imaging in differentiating benign and malignant parotid masses.Materials and Methods 47 patients with 50 parotid masses were enrolled including 25 cases with benign tumors（27 masses）,8 cases with malignant tumors and 14 cases of inflammation（15 masses）.All the masses were confirmed histopathologically and examined by CT perfusion imaging before surgery.CT perfusion parameters including blood flow（BF）,blood volume（BV）,mean transmit time（MTT） and permeability surface（PS）,peck height（PH）,time to peak（TTP） and time density curve（TDC） were evaluated.Wilcoxon sign sum test,a nonparametric test for paired data was used to determine the statistical differences of parameters between benign and malignant tumors.Results In benign tumors,BF,BV,PH were lower than those in malignant tumors（P 〈0.05 or P〈0.01） while TTP was higher than that in malignant tumors（P〈0.01）;MTT and PS had no statis-tical difference compared with those in malignant tumors（P〉 0.05）.The BV of inflammatory masses was lower than that in malignant tumors（P 〈0.01）,and TTP was higher than that in malignant tumors（P〈0.05）.The TDC shape of Warthin’s tumor was different from that of other benign and malignant tumors.Conclusion The parameters of CT perfusion such as BF,BV,PH and TTP,were valuable in distinguishing benign from malignant masses in the parotid glands.

关 键 词：腮腺疾病 体层摄影术 X线计算机 诊断 鉴别 

分 类 号：R781.7[医药卫生—口腔医学]