MRI征象在涎腺肿瘤鉴别诊断中的价值

发布时间：2018-11-07 11:47

【摘要】：目的 :探讨MRI征象在涎腺肿瘤鉴别诊断中的价值。方法 :回顾性分析经病理证实的108例涎腺肿瘤116个瘤灶的MRI表现,116个瘤灶中良性肿瘤98个,恶性肿瘤18个。观察病灶的部位、形态、边界、MR信号、强化类型、均匀性、邻近组织的浸润及颈部淋巴结情况,并与病理结果进行对照,分析不同类型涎腺肿瘤间MR征象的差异。结果:涎腺良性肿瘤的MRI表现:形态规则(71/98)、边界清楚(66/98)。所有52个多形性腺瘤T2WI表现为高信号并呈延迟强化,32个腺淋巴瘤增强后均呈中度强化,其中18个病灶T2WI表现为等信号。涎腺恶性肿瘤的MRI表现:5个黏液表皮样癌中,3个中、低度恶性者呈囊实性,边界较清晰,2个中、高度恶性者呈实性,边界不清;3个腺样囊性癌中,2个以侵犯范围广泛为特征;4个腺泡细胞癌中,1个低度恶性者与良性肿瘤较难区分,1个肿瘤直径3 cm,表现出明显浸润性生长特点;2个淋巴上皮癌呈实性,增强后中度强化;恶性多形性腺瘤(1个)表现为同时具有良性和恶性肿瘤的特点;鳞癌(1个)表现为形态不规则、蟹足样浸润;淋巴瘤(1个)和淋巴结转移瘤(1个)表现为腮腺结节合并颈部多发淋巴结肿大,结节信号与颈部肿大淋巴结一致。结论:常见涎腺良、恶性肿瘤MRI表现各有特点,对大多数病例进行鉴别诊断是可行的。
[Abstract]:Objective: to evaluate the value of MRI signs in the differential diagnosis of salivary gland tumors. Methods: the MRI findings of 116 lesions in 108 cases of salivary gland tumors confirmed by pathology were retrospectively analyzed. Among the 116 lesions, 98 were benign tumors and 18 were malignant tumors. The location, shape, boundary, MR signal, enhancement type, homogeneity, invasion of adjacent tissues and cervical lymph nodes were observed, and compared with pathological results, the differences of MR signs among different types of salivary gland tumors were analyzed. Results: MRI features of benign salivary gland tumors were regular (71 / 98) and clear border (66 / 98). All 52 pleomorphic adenomas showed high signal intensity and delayed enhancement, 32 adenomatous adenomas showed moderate enhancement after enhancement, and 18 lesions showed isointense T2WI. MRI findings of salivary gland malignant tumors: in 3 out of 5 mucoepidermoid carcinomas, the low grade malignant was cystic and solid, and the boundary was clear. In 2, the high malignant was solid and the boundary was unclear. Of the 3 adenoid cystic carcinomas, 2 were characterized by extensive invasion, 1 of the 4 acinar cell carcinomas was difficult to distinguish from benign tumors, and 1 showed a distinct invasive growth characteristic in diameter 3 cm,. 2 lymphoepithelial carcinomas presented solid, enhanced moderately, malignant pleomorphic adenoma (1) showed both benign and malignant tumors, squamous cell carcinoma (1) presented irregular morphology and crab foot-like infiltration. Lymphoma (1) and lymph node metastasis (1) showed parotid nodule with multiple cervical lymphadenopathy. Conclusion: the MRI features of common salivary gland benign and malignant tumors are different, and it is feasible to differentiate most cases.
【作者单位】：苏州大学附属第一医院影像科;贵州医科大学附属医院影像科;
【基金】：苏州市临床重点病种诊疗技术专项(LCZX201501)
【分类号】：R445.2;R739.87

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