中央气道原发涎腺型肿瘤的CT影像表现  

CT findings of primary salivary gland-type tumor in central airway

作　　者：罗洪建 陈剑 江林 LUO Hongjian;CHEN Jian;JIANG Lin(Department of Imaging,the First People’s Hospital of Zunyi,the Third Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou Province 563002,China)

机构地区：[1]遵义市第一人民医院(遵义医科大学第三附属医院)影像科,贵州遵义563002

出　　处：《实用放射学杂志》2023年第5期719-722,749,共5页Journal of Practical Radiology

摘　　要：目的探讨中央气道原发涎腺型肿瘤(SGT)的CT表现。方法回顾性分析43例经病理证实中央气道原发SGT患者的CT资料,依据病理结果分为:腺样囊性癌(ACC)28例(ACC组),黏液表皮样癌(MEC)11例(MEC组),多形性腺瘤(PA)2例,上皮-肌上皮癌(EMC)2例。所有患者术前均行CT检查,其中23例行CT增强检查,观察并记录CT征象。采用独立样本t检验比较ACC组和MEC组年龄、病灶最大径、CT值及CT增强值的差异性,采用χ^(2)检验或Fisher精确概率法比较患者的发病部位、病变形态、病变边界、周围结构、生长方式、阻塞性改变的差异性。结果ACC组、MEC组性别、年龄、临床症状无统计学差异(P>0.05)。ACC主要发生于气管或主支气管;MEC主要发生于叶、段支气管。ACC形态多表现为不规则形,边界多不清楚,周围结构多不清楚,生长方式以沿管壁弥漫性增厚及腔内生长为主,阻塞性改变少见;MEC形态多表现为结节、肿块,边界清楚,周围结构清楚,生长方式以向腔外生长为主,部分可沿管壁浸润生长,多伴有阻塞性改变。ACC组和MEC组的CT值、CT增强值均无统计学差异(P>0.05)。PA发生于气管及段支气管,EMC发生于气管,PA、EMC各有1例伴有钙化。结论中央气道原发SGT主要发生于气管及段以上支气管,其中ACC主要发生于气管,沿管壁浸润生长为主,边界不清楚,MEC主要发生于段以上支气管,类圆形为主,边界清楚。ACC、MEC是SGT的主要亚型,两者的发病部位、形态、边界、周围结构、生长方式及是否伴有阻塞性改变有统计学差异。Objective To investigate the CT features of primary salivary gland-type tumor(SGT)of central airway.Methods The CT data of 43 patients with pathologically confirmed primary SGT of central airway were analyzed retrospectively.All patients were divided into 4 groups,including adenoid cystic carcinoma(ACC)(ACC group,n=28),mucoepidermoid carcinoma(MEC)(MEC group,n=11),pleomorphic adenoma(PA)(n=2),and epithelial myoepithelial carcinoma(EMC)(n=2)according to the pathological results.Of all patients with CT examination before operation,there were 23 patients with enhancement CT scans.Then,CT signs were observed and recorded.Independent sample t-test was used to compare the differences in age,maximum diameter of lesions,CT value and CT enhancement value between ACC group and MEC group.χ^(2) test or Fisher’s exact probability test was performed to compare the differences in location,lesion morphology,lesion boundary,surrounding structure,growth pattern and obstructive changes between ACC group and MEC group.Results There were no significant differences in gender,age and clinical symptoms between ACC and MEC groups(P>0.05).ACC mainly occurred in the main bronchus or trachea,and MEC mainly located in the lobes and segmental bronchus.The morphology of ACC was mainly irregular,with unclear boundary,unclear surrounding structure,mainly growth pattern of diffuse thickening along the wall,and luminal growth,and obstructive changes were rare.The morphology of MEC was mainly nodular lesions or masses,with clear boundary,clear surrounding structure,mainly growth pattern of outward lumen or infiltration along the wall,and mainly accompanied by obstructive changes.There was no significant difference in CT value and CT enhancement value between ACC group and MEC group(P>0.05).PA occurred in trachea and segmental bronchus,and EMC occurred in trachea.There was 1 PA patient and 1 EMC patient with calcification,respectively.Conclusion The primary SGT of the central airway mainly occur in the trachea and above segmental bronchus on CT,i

关 键 词：中央气道 涎腺型肿瘤 计算机体层成像 

分 类 号：R734.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]