不同组织病理学分型腮腺黏液表皮样癌的CT征象分析  

Analysis of CT Features of Mucoepidermoid Carcinoma of Parotid Gland with Different Histopathological Types

作　　者：王明磊[1] 王娅 石亚男 赵超云 张玉 王晓东[1] WANG Minglei;WANG Ya;SHI Yanan;ZHAO Chaoyun;ZHANG Yu;WANG Xiaodong(Ningxia Medical University,Yinchuan 750004,China;Department of Radiology,the General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Radiology,Donghua Hospital,Dongguan 523111,China)

机构地区：[1]宁夏医科大学总医院放射科,银川750004 [2]宁夏医科大学临床医学院,银川750004 [3]东华医院放射科,东莞523111

出　　处：《宁夏医科大学学报》2019年第8期823-826,共4页Journal of Ningxia Medical University

摘　　要：目的分析不同组织病理分型腮腺黏液表皮样癌(mucoepidermoid carcinoma,MEC)CT征象,探讨其诊断价值。方法回顾性分析手术病理证实的25例具有完整临床和影像资料的不同分型MEC的影像学表现,25例患者均行CT平扫和增强检查。结果 25例MEC病灶中,15例为高分化型,6例为中分化型,4例为低分化型。CT示所有病灶均为单发且密度不均,可位于腮腺的深浅叶或横跨深浅叶,其中浅叶病灶较多见。病灶可呈结节或肿块样表现,高、中分化型以结节灶表现为主(73.33%、83.33%),低分化型以肿块样表现为主(75.00%)。多数高、中分化型病灶含有囊性成分,其中高分化型囊性成分所占比重大;低分化型病灶均含有片状坏死成分。低分化型病灶内可有砂砾样钙化灶(50%)。高、中分化型病灶可有假包膜(46.67%、100%)。高、中、低三型病灶多数边界不清(86.67%、50.00%、100%)。增强扫描高、中分化型病灶可呈环形或分隔样强化(33.33%、66.67%),低分化型病灶呈不均性强化,内部斑片状坏死成分无强化;1例低分化MEC部分颈部淋巴结淋巴门结构消失,明显不均匀强化。结论不同组织病理分型腮腺黏液表皮样癌CT表现具有一定特征性,能够提高术前诊断准确性,为临床制定治疗策略提供依据。Objective To analyze CT features of mucoepidermoid carcinoma of parotid gland with different histopathological types and to explore its diagnostic value. Methods The imaging findings of 25 patients with different types of MEC with complete clinical and imaging data were retrospectively analyzed.All 25 cases underwent plain CT and contrast enhancement CT scans. Results In 25 cases of MEC lesions,15 cases were highly differentiated type,6 cases were moderately differentiated type,and 4 cases were low differentiation type.CT manifestations showed that all lesions were single and density in homogenetty.They could be located in or across the deep lobes of the parotid gland,and most of them were located in the superficial lobes.The lesions might be nodular with high,moderately differentiated nodules(73.33%,83.33%)and tumor-like with low differentiation(75.00%).Most of the highly and moderately differentiated lesions contained cystic components,of which the proportion of highly differentiated cystic components was large.All the poorly differentiated lesions contained necrotic components.Sandy gravel calcification could be found in poorly differentiated lesions (50.00%).Highly and moderately differentiated lesions had false capsule(46.67%,100%).The boundary of most lesions was unclear(86.67%,50.00%,100%).High and middle differentiated lesions might be circular or septal enhancement(33.33%,66.67%),and poorly differentiated lesions showed uneven enhancement with no enhancement of internal plaque necrosis components.A case of poorly differentiated lesion was shown with disappearing lymphoid structure in partial cervical lymph nodes and obvious heterogeneous enhancement. Conclusion CT findings of mucoepidermoid carcinoma of parotid gland with different histopathological types have certain characteristics,which can improve the accuracy of preoperative diagnosis and provide basis for clinical treatment strategies.

关 键 词：腮腺 黏液表皮样癌 CT 组织病理学分型 

分 类 号：R730.44[医药卫生—肿瘤] R739.8[医药卫生—临床医学]