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0．9cm，最大径5．2cm，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）。ll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1．9cm，最大径7．6cm，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。
Objective To explore the CT findings of benign and malignant myoepithelioma in salivary gland and improve its diagnostic accuracy. Methods The CT findings of 24 patients with pathologically proved benign and malignant myoepithelioma （15 cases： 4 males and 11 females, median age 52 years old） were retrospectively reviewed. CT images were evaluated in relation to the following： location, size, morphology, margin, CT density and enhancement pattern. Resuits Benign myoepithelioma were located in parotid gland （8 cases）, submandibular gland （ 1 case）, hard palate （2 cases）, soft palate （3 cases）, root of the tongue （ 1 case）. Lesions were 0.9 - 5.2 cm in size,including oval round masses in 12 cases and lobular masses in 3 cases, the majority （ 12/15 ） of lesions demonstrated well circumscribed border. Lesions were isodense with muscle in 11 cases, slightly low density 4 cases, homogeneous density in 9 cases and inhomogeneous density in 6 cases, cystic changes in 2 cases, calcification in 1 case. On enhanced image, lesions demonstrated mild enhancement in 3 cases, marked enhancement in 8 cases on the venous phase. Malignant myoepithelioma were located in parotid gland （7 cases）, hard palate （ 1 case）, subcutaneous tissue of the maxillofacial （ 1 case）. Lesions were 1.9 ～ 7.6 cm in size, including oval round masses in 3 cases and lobular masses in 6 cases. Lesions had ill defined margin, inhomogeneous density, peripheral calcification in 1 case, bordering palate bone absorbed in 1 case. Inhomogeneous enhancement of the tumor in 7 cases on enhanced CT, internal lobulated pattern and capsular structure could be seen in 3 cases. Conclusion The CT findings of benign and malignant myoepithelioma are nonspecific, the definite diagnosis depends on pathology. Marked enhancement of masses with an internal lobulated pattern and capsular structure on venous phase may be helpful to indicate boundary benign and malignant myoepithelioma.
出处
《临床放射学杂志》
CSCD
北大核心
2014年第3期343-347,共5页
Journal of Clinical Radiology
关键词
肌上皮瘤
恶性肌上皮瘤
涎腺肿瘤
体层摄影术
X线计算机
Myoepithelioma
Malignant myoepithelioma
Salivary gland neoplasms
Tomography,X-ray computed
