良、恶性涎腺肌上皮瘤的CT表现

发布时间：2018-08-01 18:46

【摘要】：目的探讨良、恶性涎腺肌上皮瘤(ME、MM)的CT表现,以提高对该病的影像诊断水平。方法回顾性分析经手术病理证实的15例ME和9例MM的CT表现。15例ME中男4例、女11例,年龄23~68岁,中位年龄52岁;9例MM中男7例,女2例,年龄34~70岁,中位年龄53岁。对肿瘤的部位、大小、形态、边缘、CT密度及强化形式进行分析。结果 ME位于腮腺8例、颌下腺1例、硬腭2例、软腭3例、舌根1例。最小径0.9 cm,最大径5.2 cm,呈椭圆形12例、分叶状3例,边缘清晰12例、模糊3例。CT平扫呈等密度11例、稍低密度4例,密度均匀9例、不均匀6例(2例病灶内见小囊变区、1例见钙化灶)。11例病灶增强后呈轻度强化3例、显著强化8例,后者以静脉期强化明显。MM位于腮腺7例、硬腭及面颊部皮下各1例。最小径1.9 cm,最大径7.6 cm,呈椭圆形3例、分叶状6例,边缘均较模糊,1例边缘见钙化,1例相邻腭骨压迫吸收。CT平扫呈等密度7例、稍低密度2例,密度不均匀,3例病灶内见囊变区。7例病灶增强后均呈显著不均匀强化,实性部分以静脉期强化明显。结论涎腺ME和MM的CT表现无明显特征性,确诊目前仍依靠病理,但当CT增强扫描肿瘤静脉期出现显著分叶状强化,且肿块内见囊性结构时,有助于提示交界性ME和MM。
[Abstract]:Objective to investigate the CT findings of benign and malignant myoepithelioma of salivary gland (MEM) in order to improve the imaging diagnosis. Methods CT findings of 15 cases of ME and 9 cases of MM confirmed by surgery and pathology were retrospectively analyzed. Among them, 4 cases were male and 11 female, aged 2368 years. The median age of 9 cases of MM was 52 years old. There were 7 males and 2 females, aged 3470 years, with a median age of 53 years. The location, size, morphology, CT density and enhancement of the tumor were analyzed. Results ME was located in parotid gland in 8 cases, submandibular gland in 1 case, hard palate in 2 cases, soft palate in 3 cases, tongue root in 1 case. Minimal diameter 0.9 cm, maximum diameter 5.2 cm, ellipse 12 cases, lobular 3 cases, edge clear 12 cases, fuzzy 3 cases 11 cases with plain CT scan, slightly low density 4 cases, homogeneous density 9 cases. There were 3 cases with slight enhancement and 8 cases with obvious enhancement after enhancement. In the latter cases, 7 cases were in the parotid gland, 1 case in the hard palate and 1 case in the buccal region. The smallest diameter was 1.9 cm, the maximum diameter was 7.6 cm, and it was oval in 3 cases, lobular in 6 cases. Calcification was seen in 1 case, palatine bone compression absorption in 1 case was isodensity in 7 cases, and low density in 2 cases. In 3 cases with nonuniform density, 7 cases of cystic lesions showed obvious enhancement after enhancement, and the solid part was obviously enhanced in venous phase. Conclusion the CT findings of ME and MM in salivary gland have no obvious characteristic, and the diagnosis is still pathological at present. But when CT enhanced CT scan the tumor in vein phase, significant lobular enhancement, and cystic structure in the tumor, it is helpful to indicate the borderline ME and MM.
【作者单位】：贵阳医学院附属医院影像科;
【分类号】：R739.8;R730.44

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