多层螺旋CT双期增强扫描廓清衰减值鉴别诊断腮腺基底细胞腺瘤和沃辛瘤  

Diagnosis of the Washout Attenuation Value in Differentiating Basal Cell Adenoma from Warthin Tumor of the Parotid Gland via Dual Phase Enhanced Scans of Multi-Slice Computed Tomography

作　　者：赵丽丽 许志高[1] 武金龙[1] 孙雪松 彭泰松 郭文强 ZHAO Lili;XU Zhigao;WU Jinlong;SUN Xuesong;PENG Taisong;GUO Wenqiang(Department of Medical Imaging,the Third People's Hospital of Datong,Datong 037008,China;不详)

机构地区：[1]大同市第三人民医院医学影像科,山西大同037008 [2]大同市第三人民医院医务科,山西大同037008 [3]大同市第二人民医院医学影像科,山西大同037008 [4]山西大同大学医学院临床医学系,山西大同037008

出　　处：《中国医学影像学杂志》2022年第11期1108-1112,共5页Chinese Journal of Medical Imaging

基　　金：大同市重点(社会发展)项目(2020087)。

摘　　要：目的探讨多层螺旋CT双期增强扫描廓清衰减值对腮腺基底细胞腺瘤(BCA)与沃辛瘤的鉴别诊断价值。资料与方法回顾性分析2016年1月—2019年10月大同市第三人民医院经病理证实的16例腮腺BCA和32例沃辛瘤的临床资料及多层螺旋CT双期增强扫描图像,观察病灶一般形态学特征及强化方式,测量肿瘤平扫CT值、双期增强扫描动脉期和静脉期CT值,计算两期廓清衰减值。比较两组肿瘤的强化方式并定量分析廓清衰减值对两者的诊断价值。结果腮腺BCA和沃辛瘤病灶均好发于腮腺浅叶,边缘清晰,可发生囊变,钙化少见,肿瘤大小差异无统计学意义(P均>0.05)。16例BCA均为单发病灶;32例沃辛瘤中,14例为单发,18例为多发。两组肿瘤实质部分平扫CT值和动脉期CT值差异无统计学意义(P>0.05),静脉期CT值差异有统计学意义(P<0.001);两组肿瘤强化方式均以廓清型为主,15例BCA、31例沃辛瘤表现为廓清型,两组强化方式差异无统计学意义(P>0.05)。当廓清衰减值<20 Hu时,多为BCA;廓清衰减值≥20 Hu时,以沃辛瘤为主。结论腮腺BCA和沃辛瘤在多层螺旋CT双期增强扫描中强化方式相似,难以鉴别;对廓清衰减值进行定量分析有助于更好地鉴别两者。Purpose To explore the differential diagnosis of the washout attenuation value in basal cell adenoma(BCA)and Warthin tumor of the parotid gland via multi-slice computed tomography(MSCT).Materials and Methods The clinical data and the MSCT dualphase enhanced scan images of the patient pathologically confirmed with parotid gland tumors(including 16 patients with BCA and 32 patients with Warthin tumor)in the Third People’s Hospital of Datong from January 2016 to October 2019 were retrospectively analyzed.The general morphological characteristics and the enhancement patterns of the lesions were observed.The attenuation values on each phase of CT scans including non-enhanced CT value,arterial CT value and venous CT value were also measured,and the washout attenuation value of the dualphase(the attenuation value of the arterial phase minus the attenuation value of the venous phase)were further calculated.The enhancement patterns and quantitative analyses were compared to obtain the diagnostic value of the washout attenuation value between the two groups.Results All BCA and Warthin tumors were all located in the superficial lobe of the parotid gland,with well-defined feature,cystic degeneration,and rarely with calcification,there was no significant difference in the above features and tumor size between the two groups(P>0.05).All 16 tumors of BCA were single lesion.Of the 32 lesions of Warthin tumor,14 cases were single lesion and 18 cases were multiple lesions.There was no statistical difference in non-enhanced CT value and CT value of arterial phase between the two groups(P>0.05),however,there was significant difference in CT value of venous phase between the two groups(P<0.001).The enhancement patterns of all tumors mainly showed the washout pattern,including 15 BCA and 31 Warthin tumors,and there was no significant difference in enhancement patterns between the two groups(P>0.05).Moreover,BCA was the most common tumor when the washout attenuation value was less than 20 Hu,and Warthin tumor was the main tumor when

关 键 词：基底细胞腺瘤 沃辛瘤 体层摄影术 螺旋计算机 腮腺 廓清衰减值 病理学 外科 诊断 鉴别 

分 类 号：R739.91[医药卫生—肿瘤] R730.42[医药卫生—临床医学]