19例腮腺腺泡细胞癌的MRI影像表现分析  

MRI findings of parotid acinic cell carcinoma in 19 consecutive cases

作　　者：肖华[1] 陶晓峰[1] 朱文静[1] 陈倩倩[1] XIAO Hua;TAO Xiao-feng;ZHU Wen-jing;CHEN Qian-qiann(Department of Radiology,Shanghai Ninih People's Hospilal,hanghai Jiao Tong Universily School of Medicine,Shanghai 200011 China)

机构地区：[1]上海交通大学医学院附属第九人民医院放射科,上海200011

出　　处：《上海口腔医学》2022年第3期322-326,共5页Shanghai Journal of Stomatology

基　　金：国家自然科学基金(91859202、81771901)。

摘　　要：目的:总结腮腺腺泡细胞癌(acinar cell carcinoma,AciCC)的 MRI 特征,探讨 MR 功能成像的诊断价值。 方法:分析 269 例经手术病理证实的颌面部 AciCC 的临床资料。 其中,19 例腮腺 AciCC 行术前 MRI 检查(1 例平扫,18 例增强),17 例行 DWI 扫描, 15 例行 DCE 扫描。 回顾分析 19 例患者的 MRI 表现,分析病灶大小、部位、形态、边缘、内部结构、强化方式及功能成像特点。 采用 SPSS 25.0 软件包对数据进行统计学分析。 结果:269 例颌面部 AciCC 中,男108 例,女 161 例,男∶女=1∶1.49。 年龄 4~89 岁,平均年龄(45.95±17.33)岁。84.4%(227/269)的发病部位位于腮腺。MRI表现为 78.9%(15/19)病变边界清晰,57.9%(11/19)呈圆形或椭圆形,36.8%(7/19)呈分叶状结节。 1 例病变形态不规则,且侵犯外周。 病灶最大径 6~56 mm,平均(24.8±15.3) mm。 内部结构为 57.9%(11/19)呈囊实性,42.1%(8/19)呈实性,31.6%(6/19)有出血。 T2 加权像 52.6%(10/19)可见包膜结构,15.8%(3/19)内部见低信号分隔;38.9%(7/18)强化均匀,61.1%(11/18)强化不均匀。 功能成像显示肿瘤平均 ADC 值为(1.026±0.194)×10;mm;/s(n=17),86.7%(13/15)TIC 为Ⅱ型。 结论:绝大部分颌面部 AciCC 位于腮腺。 常规 MRI 显示,AciCC 形态学上与良性肿瘤较难鉴别。 功能成像 ADC 值较良性肿瘤低,TIC 曲线类型多为Ⅱ型。 将形态学与功能成像相结合,可提高该病的诊断准确率。PURPOSE: To describe the MRI features of acinar cell carcinoma of parotid gland (AciCC) and to evaluate the diagnostic value of MR functional imaging. METHODS: A total of 269 cases of maxillofacial AciCC confirmed by surgery and pathology were analyzed. Among them, nineteen subjects with AciCC in the parotid gland underwent preoperative MRI examination (non -enhanced scan for one case, enhanced scan for 18 cases), seventeen patients underwent diffusion-weighted imaging scan, and 15 patients underwent dynamic contrast-enhanced scan. MRI findings of 19 patients were retrospectively analyzed. The lesion size, location, morphology, margin, internal composition, enhancement pattern and functional imaging characteristics were analyzed. SPSS 25.0 software package was used for statistical analysis.RESULTS: Among 269 cases of maxillofacial AciCC, there were 108 males and 161 females, male: female = 1:1.49, aged from 4 to 89 years, with a mean age of (45.95±17.33) years. 84.4% (227/269) were located in the parotid gland. On MRI images, 78.9% (15/19) had well-defined margin, 57.9% (11/19) were round or oval, and 36.8% (7/19) were lobed nodules.One case had irregular morphology and peripheral invasion. The range of maximum diameter was 6 -56 mm, averaging(24.8±15.3) mm. Internal composition showed 57.9% (11/19) were cystic solid, 42.1% (8/19) were solid, 31.6% (6/19) had bleeding. T2-weighted MRI showed 52.6% (10/19) with envelope structure, 15.8% (3/19) with low signal separation inside,38.9%(7/18) had uniform enhancement, and 61.1%(11/18) had uneven enhancement. Functional imaging showed the mean ADC value of tumor was (1.026 ±0.194) ×10;mm~2/s (n =17). 86.7% (13/15) TIC was type Ⅱ . CONCLUSIONS: Most maxillofacial AciCC are located in the parotid gland. It is difficult to distinguish AciCC from benign tumors with conventional MRI in morphology. The ADC value of AciCC is lower than that of benign tumors, and the type of TIC curve is mostly type Ⅱ. Combination of morphology and functional imaging can improve the dia

关 键 词：腮腺 腺泡细胞癌 磁共振成像 功能成像 

分 类 号：R739.8[医药卫生—肿瘤]