原发性气管腺样囊性癌影像学特点分析  

Image Characteristics of Primary Tracheal Adenoid Cystic Carcinoma

作　　者：张云轩[1] 韩小雨 史河水[2] ZHANG Yunxuan;HAN Xiaoyu;SHI Heshui(CT Room,Huangshi Municipal Second Hospital,Hubei Province 435000,P.R.Chin)

机构地区：[1]湖北省黄石市第二医院CT室,435000 [2]华中科技大学同济医学院附属协和医院放射科,武汉430000

出　　处：《临床放射学杂志》2018年第7期1121-1125,共5页Journal of Clinical Radiology

摘　　要：目的分析原发性气管腺样囊性癌（ACC）的影像学特点,以提高对该类疾病的诊断及鉴别诊断水平。方法回顾性分析经病理证实的13例原发性气管ACC患者的影像学检查,包括13例CT检查资料,其中增强扫描9例,并进行MPR和VRT等CT后处理观察并评价病变;X线检查4例;MRI检查2例,PET/CT检查4例。结果ACC患者女性居多（9/13,69.2%）,平均年龄（46±16）岁（范围22~68岁）。13例肿瘤均位于气管,其中胸段气管10例,颈段气管3例,同时累及胸段气管与主支气管3例;ACC多表现为腔内宽基底肿物（6/13,46.2%）,其中5例（38.5%）沿气管壁浸润生长,2例（15.4%）为气管腔内外肿物;形态上ACC以分叶状肿物（7/13,53.8%）或弥漫性管壁增厚为主（5/13,38.5%）,仅1例（7.7%）为类圆形肿物;ACC平扫密度一般较均匀（9/13,69.2%）,且多低于胸壁肌肉密度（12/13,92.3%）,增强扫描以轻度强化为主（6/9,66.7%）。结论原发性气管ACC好发于40岁左右女性,临床症状缺乏特异性,病变主要位于胸段气管,CT表现为宽基底肿物或管壁环形增厚,平扫密度较均匀,以轻度强化为主。Objective To analyze the image features of primary tracheal adenoid cystic carcinoma（ ACC） and therefore to improve the diagnosis. Methods Collected and analyzed the image features of 13 cases with primary tracheal adenoid cystic carcinoma confirmed by pathology,retrospectively. All cases had non-enhanced CT scans（ among which 9 cases underwent CT scan with contrast）,then post-processing such as MPR and VRT was performed to observe and evaluate the lesions,four cases had X-ray data and five underwent PET/CT imaging and two underwent MR imaging,respectively. Results ACC was more frequent in female（ 9/13,69. 2%）,and the average age at diagnosis was 46 ± 16 years（ range,22-68 years）. All ACC located at trachea（ cervical trachea： 3; thoracic trachea： 10）,and 3 cases of tumor located at trachea and main bronchi at the same time. Most cases of ACC（ 6/13,46. 1） presented intraluminal nodules with wide base,5 cases（ 38. 5%） presented infiltrating growth and diffuse wall thickening,2 case（ 15. 4%） presented intra-and extraluminal extension. The shape of ACC tumors was mainly lobulated（ 7/13,53. 8%） or present as circumferential wall thickening（ 5/13,38. 5%）,only one case show round nodule（ 7. 7%）. Most tumors of ACC showed even density（ 9/13,69. 2%）,the majority density of ACC were lower than that of chest wall muscle（ 12/13,92. 3%）,showed mild enhancement（ 6/9,66. 7%）.Conclusion ACC usually occurred in females in their 40 s,mostly located at thoracic trachea,and presented circumferential wall thickening or lobulated mass. Most ACC showed even density with mild enhancement.

关 键 词：腺样囊性癌 涎腺肿瘤 多层螺旋CT 

分 类 号：R730.44[医药卫生—肿瘤] R734.1[医药卫生—临床医学]