腮腺腺泡细胞癌的CT、MRI表现与病理对照分析  

CT and MRI Findings of Acinic Cell Carcinoma of Parotid Gland:Comparison Study with Pathological Results

作　　者：江明祥[1,2] 张敏鸣[1] 邵国良[1] 邝平定[1] 

机构地区：[1]浙江大学医学院附属第二医院放射科,杭州310009 [2]浙江省肿瘤医院放射科,310022

出　　处：《临床放射学杂志》2014年第4期494-498,共5页Journal of Clinical Radiology

摘　　要：目的探讨腮腺腺泡细胞癌(ACCP)的CT、MRI表现。方法搜集经手术病理证实的20例ACCP患者的CT和MRI资料(14例CT检查,6例MRI检查),回顾性分析肿瘤的部位、大小、形态、边缘、CT密度或MRI信号及强化形式,并与病理结果相对照。结果 20例均为单发肿瘤,16例位于腮腺浅叶,4例位于腮腺深叶。病灶最大径<3 cm者18例,呈边缘光整、类圆形或椭圆形肿块,病灶与周围组织分界清晰;>3 cm者2例,呈边缘不光整、不规则分叶状肿块,病灶周围脂肪间隙模糊,其中1例侵犯耳前皮肤,1例包绕下颌后静脉。密度(信号)均匀4例,不均匀16例。14例CT平扫病灶呈稍低密度5例,等密度9例;6例MRI病灶信号T1WI呈等信号,T2WI呈混杂高信号。增强扫描病灶呈明显强化15例,中度强化3例,轻度强化2例。结论 ACCP的影像表现不具有特征性,确诊最终依靠病理,CT、MRI检查可以准确显示病灶的范围,为临床制定治疗方案提供客观依据。Objective To investigate CT and MRI manifestations of acinic cell carcinoma in parotid gland, and to compare the imaging findings with the pathological results. Methods A total of 20 patients with pathologically-proved acinic cell carcinoma were enrolled in this study. CT scanning was performed in 14 cases and MRI in 6 cases. The imaging mate- rials were retrospectively analyzed. The location, size, shape, margin of the lesion, and CT density or MRI signal intensity as well as the enhancement pattern were evaluated. The findings were compared with the pathologic results. Results The disease was marked by a single tumor in all 20 patients, which was located in the superficial lobe （n = 16） or in the deep lobe （ n = 4）. In 18 cases the largest diameter of the lesion was 〈 3 cm, the tumor took the form of a round or oval round mass with a smooth border and a clear demarcation with the surrounding tissue. In 2 cases, the lesion was 〉 3 cm, presen- ting as an irregular mass with foggy edge, and the surrounding fatty space was blurred. The preauricular skin was involved in one case and the retromandibular vein was embedded in the tumor in another case. Homogeneous CT density or MRI sig- nal intensity was seen in 4 cases, while heterogeneous CT density or MRI signal intensity was found in 16 cases. On plain CT scanning in 14 cases, slightly low-density was seen in 5 cases and isodense shadow in 9 cases. On MRI of 6 cases, the lesions showed iso-signal on T1WI and mixed hyperintense signal on T2WI. Contrast-enhanced scanning revealed that obvi- ous enhancement could be detected in 15 cases, moderate enhancement in 3 cases and slight enhancement in 2 cases. Conclusion It seems that acinic cell carcinoma of parotid gland has no pathognomonic imaging sings, therefore, the con- firmation of the diagnosis should be dependent on the pathologic examination. Both CT and MRI can precisely demonstrate the extent of the lesion, providing useful information for the making of therapeutic scheme.

关 键 词：腮腺 腺泡细胞癌 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.8[医药卫生—肿瘤]