腮腺肌上皮瘤的CT表现及文献复习  

CT performances and literature review of myoepithelioma of the parotid gland

作　　者：刘海洋[1] 侯丹玮 任英红 LIU Haiyang;HOU Danwei;REN Yinghong(Department of Medical Imaging,Shangluo Central Hospital,Shangluo,Shaanxri Province 726000,China;Department of Cancer Diagrosis and Treatment Center,Shangluo Central Hospital,Shangluo,Shaanxn Province 726000,China)

机构地区：[1]商洛市中心医院医学影像科,陕西商洛726000 [2]商洛市中心医院肿瘤诊治中心,陕西商洛726000

出　　处：《实用放射学杂志》2019年第11期1736-1738,1767,共4页Journal of Practical Radiology

摘　　要：目的探讨腮腺肌上皮瘤(ME)的CT征象及文献复习,提高对该病的认识及诊断正确率.方法回顾性分析12例经手术病理证实的腮腺ME的CT表现特征,分析其发病年龄、性别、大小、部位、密度、边界、强化等特点并复习相关文献.结果12例患者中,男5例,女7例,年龄11~68岁,中位年龄45.2岁,2例伴压痛及发热,其余10例为无症状耳前无痛性肿块,其中2例肿块逐渐增大.本组均为单发肿块,2例可见包膜浸润或界限不清,10例包膜完整或边缘光整.CT显示肿块均位于腮腺腺体内,1例位于深叶,11例位于浅叶;肿块直径10~50 mm,平均29.1 mm;2例密度较均匀,10例伴有不规则囊变和坏死;增强扫描后动、静脉期均有轻度强化,其中8例动脉期边缘强化或结节状强化,静脉期逐渐向中心充填较具特征性的表现.结论腮腺ME的CT表现具有一定的特征性,结合腮腺浅叶边界清楚的单发囊实性肿块,增强后持续向心性强化,应考虑到该病的可能.当肿瘤包膜不完整或与周围结构界限不清时,应考虑恶性肌上皮瘤(MM).Objective To study the CT performances and literature review of myoepithelioma(ME)of the parotid gland,to improve the recognition and diagnostic accuracy of this disease.Methods The CT findings of 12 cases with ME of the parotid gland confirmed by surgery and pathology were analyzed retrospectively,the characteristics of the age of onset,gender,size,location,density,boundary and enhancement were analyzed.And then,the related literatures were reviewed.Results Among the 12 patients,5 were male and 7 were female,age ranged from 11 to 68 years old,with a median age of 45.2 years.2 patients had the symptom of tenderness and fever,and the other 10 patients were asymptomatic and painless preauricular mass,2 of which were gradually enlarged.All the tumors were single in this study,2 had visible capsule infiltration or unclear boundaries,and other 10 had intact or smooth edges.CT showed that the masses all located in the parotid gland(1 in the deep lobe and 11 in the superficial lobe).The diameter of the tumor was 10 mm to 50 mm,with an average of 29.1 mm.The density was uniform in 2 cases and irregular cystic degeneration and necrosis in the other 10 cases.Mild enhancement was found in the arteriovenous phase after enhanced scanning,in which 8 cases had marginal enhancement or nodular enhancement in the arterial phase,and gradual filling into the center in the venous phase.Conclusion The CT performances of ME of the parotid gland have define characteristics.The possibility of myoepithelioma of the parotid gland should be taken into account when it has continuous centripetal reinforcement after enhancement,combing with the single cystic solid mass with clear boundary in superficial lobe of the parotid gland.Malignant myoepithelioma(MM)should be considered when the tumor envelope is incomplete or the boundary with the surrounding structure is not clear.

关 键 词：腮腺肿瘤 肌上皮瘤 计算机体层成像 

分 类 号：R739.91[医药卫生—肿瘤] R814.42[医药卫生—临床医学]