CT和MRI在腮腺良、恶性肿瘤鉴别诊断中的价值  

Diagnostic value of CT and MRI in benign and malignant tumors of parotid gland

作　　者：唐晨虎[1] 马东 孙伟[1] 赵文超 谈瑞生 陈新[1] TANG Chen-hu;MA Dong;SUN Wei;ZHAO Wen-chao;TAN Rui-sheng;CHEN Xin(Department of Radiology,Nanjing Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Traditional Chinese Medicine,Nanjing 210014,China;Department of Radiology,Zhenjiang Traditional Chinese Medicine Hospital,Zhenjiang Jiangsu 212003,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院放射科,江苏南京210014 [2]镇江市中医院影像科,江苏镇江212003

出　　处：《中国临床医学影像杂志》2021年第2期90-93,103,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:研究CT及MRI对腮腺良恶性肿瘤的鉴别诊断价值。方法:以2016年1月—2019年2月收治的69例在我院治疗的腮腺肿瘤患者作为研究对象,良性病变49例,恶性病变20例,分别对两组患者开展CT和MRI检查,分析不同病变的CT和MRI检查结果之间的差异。结果:良性肿瘤CT检查边界清晰、钙化及囊变检出率高于恶性肿瘤(P<0.05),良性肿瘤体积小于恶性肿瘤(P<0.05);两组患者的DCE-MRI时间-信号强度曲线之间的差异存在统计学意义(P<0.05),良性组中,多形性腺瘤主要以Ⅰ型DCE-MRI时间-信号强度曲线为主,腺淋巴瘤主要以Ⅱ型DCE-MRI时间-信号强度曲线为主,恶性肿瘤主要以Ⅲ型DCE-MRI时间-信号强度曲线为主,良性肿瘤ADC数值平均为1.69±0.19,恶性肿瘤的ADC数值平均为1.02±0.15,良性肿瘤的ADC数值高于恶性组(t=14.062,P=0.000);恶性肿瘤与边界清晰率、钙化及囊变率、ADC呈负相关,与患者的DCE-MRI时间-信号强度曲线、肿瘤大小呈正相关(P<0.05);对于恶性腮腺肿瘤的诊断,联合诊断特异度(65.12%)高于CT和MRI单独检测(48.98%,18.37%)。结论:通过对患者的CT和MRI的联合诊断,可提升对恶性腮腺肿瘤患者的诊断效能。Objective:To study the significance of CT and MRI in the differential diagnosis of benign and malignant tumors of parotid gland.Methods:From January 2016 to February 2019,69 patients with parotid gland tumor treated in our hospital were taken as the research objects,including 49 cases of benign lesions and 20 cases of malignant lesions.CT and MRI were performed on the two groups of patients respectively,and the differences between CT and MRI results of different lesions were analyzed.Results:On the CT images,benign tumor had clear boundary,the calcification and cystic change detection rate was higher than that of malignant tumor(P<0.05).The benign tumor volume was smaller than malignant tumor(P<0.05).The difference of DCE-MRI time signal intensity curve between the two groups was statistically significant(P<0.05).In benign tumor group,most pleomorphic adenoma were typeⅠDCE-MRI time-signal intensity curve,most adenolymphomas were mainly typeⅡDCE-MRI time-signal intensity curves,and most malignant tumors were typeⅢDCE-MRI time-signal intensity curve.The ADC value of benign tumor was 1.69±0.19 and that of malignant tumor was 1.02±0.15.The ADC value of benign tumor was higher than that of the malignant group(t=14.062,P=0.000).Malignant tumor were negatively correlated with the rate of sharpness of borders,calcification,cystic degeneration,and ADC value,and were positively correlated with DCE-MRI time-signal intensity curve and tumor size(P<0.05).For the diagnosis of malignant parotid gland tumor,the specificity of combined diagnosis(65.12%)was higher than that of CT and MRI alone(48.98%,18.37%).Conclusion:The combined diagnosis of CT and MRI can significantly improve the diagnosis efficiency of patients with malignant parotid tumor.

关 键 词：腮腺肿瘤 磁共振成像 体层摄影术 螺旋计算机 

分 类 号：R739.8[医药卫生—肿瘤] R445.1[医药卫生—临床医学]