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腮腺粘液表皮样癌的CT诊断及鉴别诊断(附3例报告)

作者:吴红珍 江新青 魏新华 陈 亮 郭 媛

所属单位:广州市第一人民医院放射科(广东 广州 510180)

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摘要

目的探讨腮腺粘液表皮样癌的 CT特征和诊断价值。方法 回顾性分析经 手术及病理证实的3例腮腺粘液表皮样癌 患者CT表现,均进行CT平扫及增强扫描。 结果 1例发生在右侧腮腺,2例为左侧, 均发生于浅叶,最大径为1.1-2.1cm,其 中1例表现为多结节并融合,另外2例为类 圆形结节影,平扫CT值约50-60Hu,相对 于腮腺呈稍高密度,边界欠清楚,增强扫 描CT值约90-130Hu,1例强化较均匀,1例 欠均匀强化,另外1例多结节型可见囊变 坏死区。双侧颈动脉鞘区未见明显肿大 淋巴结。上述3例CT均误诊为良性病变, 考虑腺淋巴瘤或混合瘤。结论 腮腺粘液 表皮样癌CT表现无特异性,主要为边界欠 清,提示肿瘤向周围组织浸润,强化较明 显提示肿瘤血供较丰富,这些应考虑到恶 性病变可能,最终确诊仍需依靠病理学检 查。

Objective To Analyze CT characteristics, and the diagnosis value of CT on mucoepidermoid carcinoma of parotid gland. Methods Retrospective analysis CT manifestations for 3 cases of mucoepidermoid carcinoma of the parotid gland which confirmed by the surgical and pathological, plain and enhanced CT scan were performed. Results One case occurred in the right and two cases in the left of parotid gland, all occurred in the superficial, the maximum diameter was 1.1-2.1cm, one appeared to be multiple nodules and fusion, two were round nodule. CT value was about 50-60Hu when unenhanced, slightly dense was relative to the parotid gland, boundaries were not clear, CT value was around 90-130Hu when enhanced,one cases strengthen more evenly, one case strengthened uneven, one was multiple nodules with cystic necrosis. No significant enlarged lymph nodes in bilateral common carotid artery sheath area. 3 cases werd misdiagnosed as benign lesions, such as adenolymphoma or mixed tumors. Conclusion CT manifestations of mucoepidermoid carcinoma of the parotid gland without specificity, boundary was not clear would prompt tumor-infiltrating surrounding tissue ,significantly enhanced would prompt tumor blood supply was rich, these were prompted for malignant tumor, but still need to rely on pathological examination to confirmed it.

【关键词】腮腺;粘液表皮样癌;体层摄 影术,X线计算机

【中图分类号】R781.7+3

【文献标识码】A

【DOI】 10.3969/j.issn.1672-5131.2015.02.04

前言

粘液表皮样癌(mucoepidermoid carcinoma,MEC)是最常见的涎 腺恶性肿瘤,也是腮腺恶性肿瘤中最常见的一种,发病率占腮腺恶性 肿瘤的首位,主要来源于腺管上皮细胞,因其临床表现类似多形性腺 瘤,术前易误诊。本文就3例具有完整临床、CT资料的粘液表皮样癌进 行总结分析。