MSCT双期增强及动态增强鉴别腮腺多形腺瘤与腺淋巴瘤临床价值分析  

Analysis of clinical value of MSCT dual phase enhanced scanning and dynamic enhancement in differential diagnosis of parotid gland pleomorphic adenoma and adenolymphoma

作　　者：梁久平[1] 胡钰 陈惠枚[1] 原志娜 宋建勋[1] LIANG Jiuping;HU Yu;CHENG Huimei;YUAN Zhina;SONG Jianxun(Department of Radiology, the people's hospital of BaoAn, Shenzhen,Guangdong,518101, P.R.China)

机构地区：[1]广东省深圳市宝安区人民医院放射科,广东深圳510101

出　　处：《医学影像学杂志》2021年第11期1855-1858,共4页Journal of Medical Imaging

摘　　要：目的探讨MSCT双期及动态增强扫描鉴别腮腺多形腺瘤(PA)与腺淋巴瘤(Warthin)的临床价值。方法选取MSCT平扫及增强扫描的PA和Warthin瘤41例52个病灶,双期增强29例,动态增强12例,对比分析两种增强方式的临床价值。结果1)PA和Warthin瘤平扫CT值差异有统计学意义(P=0.003),以41 HU作为阈值,敏感度为71.4%,特异度为80.0%;动脉期CT值差异有统计学意义(P=0.000),以79 HU作为阈值,敏感度为78.6%,特异度为95.0%;静脉期CT值差异无统计学意义(P>0.05);2)双期增强19例PA呈持续强化,1例PA静脉期强化减退;2例Warthin瘤呈持续强化,12例Warthin瘤静脉期强化减退(P=0.000),鉴别诊断PA与Warthin瘤的灵敏度为95.0%,特异度为85.7%;3)动态增强7例PA和1例Warthin瘤呈缓慢上升型曲线,10例Warthin瘤呈速升速降型曲线;鉴别诊断PA与Warthin瘤的灵敏度为100%,特异度为90.9%。结论MSCT平扫及增强对鉴别PA与Warthin瘤具有重要临床意义,双期增强扫描可作为首选增强扫描方式。Objective To compare and analyze the clinical value of MSCT dual phase enhanced scanning and dynamic enhanced scanning to the differential diagnosis of parotid gland pleomorphic adenoma(PA)and adenolymphoma.Methods A total of 41 patients with 52 lesions who underwent plain and enhanced MSCT before surgery were enrolled.20 PA(20 lesions)and 9 adenolymphoma(14 lesions)underwent dual phase enhanced scans;7 PA(7 lesions)and 5 adenolymphoma(11 lesions)underwent dynamic enhancement scans;The clinical value of the two enhanced scanning methods in differential diagnosis PA and adenolymphoma was analyzed.Results 1)The plain CT values of PA and adenolymphoma were statistically significant(P=0.003).41 HU was used as the best diagnostic cutoff point.The sensitivity was 71.4%and the specificity was 80.0%.The CT values of the arterial phase of the dual phase enhanced scanning were statistically significant(P=0.000).With 79HU as the best diagnostic cutoff point,the sensitivity was 78.6%.The specificity was 95.0%.There was no significant difference in venous CT value between the two enhanced scans(P>0.000);2)with MSCT dual phase enhanced scan,19 PA showed continuous enhancement and 1 case showed wash-out;2 adenolymphomas showed continuous enhancement and 12 cases showed wash-out;there were differences between the two groups(P=0.000).The sensitivity of differential diagnosis of pleomorphic adenoma and adenolymphoma was 95.0%,and the specificity was 85.7%;3)with MSCT dynamic enhanced scan,the dynamic curves of 7 PA and 1 adenolymphoma showed gradually rising pattern,and 10 adenolymphoma showed"wash-out".The sensitivity of differential diagnosis of PA and adenolymphoma was 100%and specificity of 90.9%.Conclusion MSCT plain scanning and enhanced scanning of the parotid gland have important clinical value to differential diagnosis of PA and adenolymphoma,and dual phase enhanced scanning can be the first choice for parotid enhancement.

关 键 词：腮腺 多形腺瘤 腺淋巴瘤 体层摄影术 X线计算机 增强扫描 

分 类 号：R739.87[医药卫生—肿瘤] R814.42[医药卫生—临床医学]