颌面部恶性肌上皮瘤的CT影像和病理特征  

CT imaging and pathological features of maxillofacial malignant myoepithelioma

作　　者：蔡宁[1] 董越[2] 程凡容 胡亮[1] 王丽君[1] 苗延巍[1] 刘爱连[1] 

机构地区：[1]大连医科大学附属第一医院放射科,辽宁大连116011 [2]中国医科大学肿瘤医院辽宁省肿瘤医院

出　　处：《实用放射学杂志》2016年第7期1020-1022,1032,共4页Journal of Practical Radiology

基　　金：辽宁省省直医院改革重点临床科室诊疗能力建设项目（LNCCC-D43-2015）.

摘　　要：目的：探讨颌面部恶性肌上皮瘤（MME）的 CT 影像和病理特征。方法对8例经病理证实的颌面部 MME 患者手术病理和 CT 平扫及增强影像进行回顾性分析,评价 CT 上病灶的位置、数量、形态、大小、平扫及双期增强扫描的 CT 值变化特征。结合病理学结果,提高 MME CT 征象的认识。结果8例病灶均为单发,透明细胞和梭形细胞构成的混合型5例,上皮样细胞与浆细胞构成的混合型2例,透明细胞型1例。病灶均为分叶状,边界模糊,平扫密度不均,小囊变多见,1例病灶内见点状钙化,2例邻近骨质破坏；增强扫描病灶不均匀中等或显著强化,小囊状、线样及裂隙样不强化区多见,动脉期病灶内可见迂曲小血管影,大部分见小棘状突起。结论颌面部恶 MME 有不同的病理亚型,CT 表现具有一定特征性,CT 对 MME 诊断具有一定价值。Objective To evaluate CT imaging and pathological features of maxillofacial malignant myoepithelioma （MME）. Methods A total of eight patients with pathologically confirmed MME of the maxillofacial region were underwent non-enhanced and contrast-enhanced CT scans.CT features of the lesions were assessed as follows：location,number,shape,size,enhancement pattern and CT number on non-enhanced and contrast-enhanced scan.CT features were compared with the pathological results.Results All the lesions were unilateral,in which mixed type with clear cells and spindle cells in 5 cases,mixed type with epithelioid cells and plas-ma cells in 2 cases,and clear cell type in one case.8 cases were manifested as lobulated mass.On non-enhanced scan,the density of all the lesions were hetergeneous with cystic area,1 case with calcification and 2 cases with bone destruction.On the contrast-en-hanced CT,all the lesions were showed hetergeneously moderate or obvious enhancement,and cystic,line and crack areas without the enhancement were observed.Minor vessel and spiculate protuberance of marginal zone on the arterial phase were observed in most le-sions.Conclusion MME has different pathological subtypes and characteristic CT features.CT is an effective method to diagnose MME.

关 键 词：颌面部 恶性肌上皮瘤 计算机体层成像 病理学 

分 类 号：R739.81[医药卫生—肿瘤] R814.42[医药卫生—临床医学]