摘要
目的探讨腮腺区木村病的CT、MRI影像特征。方法该研究为横断面研究,回顾性收集2018年1月至2023年6月上海交通大学医学院附属第九人民医院经术后病理证实的40例腮腺区木村病患者,男36例、女4例,年龄(46±19)岁,范围8~74岁。分析其临床资料及术前CT、MRI影像学表现。对接受MRI检查的患者,测量病灶表观扩散系数(ADC)值,分析时间-信号强度曲线(TIC)类型。结果木村病患者男女比例为9∶1,临床病程为1个月~20年,37例(92.5%,37/40)患者外周血嗜酸性粒细胞比例增高。40例患者中,结节型4例,弥漫型34例,中间型2例。结节型:4例均位于单侧腮腺浅叶,3例为多发病灶。病灶为类圆形,边界清晰,密度或信号均匀。2例病灶T 2WI呈均匀高信号,增强后明显均匀强化,TIC为平台型,ADC值为0.74×10^(-3) mm^(2)/s、0.82×10^(-3) mm^(2)/s。弥漫型:22例为多发病灶,20例伴有头颈部其他部位皮下病变。病灶形态不规则,边界模糊,33例累及邻近皮下组织及皮肤。病灶密度或信号不均匀,15例接受MRI的患者中14例病灶T 2WI呈不均稍高信号伴条状低信号,增强后呈中度或明显强化,TIC呈持续上升型9例、平台型6例。ADC值为(0.99±0.21)×10^(-3) mm^(2)/s。中间型:2例均为单发病灶,形态不规则,未累及邻近皮下组织及皮肤,增强明显强化,无坏死。28例弥漫型和2例结节型木村病伴有同侧或双侧颈部淋巴结肿大,肿大淋巴结边界清楚,密度或信号均匀,增强均匀强化。结论腮腺区木村病临床病程较长及外周血嗜酸粒细胞增多,形态上以弥漫型多见,腮腺内及腮腺周围皮下多发边界不清的病变,同时可伴有头颈部其他部位类似表现的皮下病变,明显强化,伴有颈部淋巴结肿大,TIC呈持续上升型或平台型,ADC值低。结节型和中间型少见。
ObjectiveTo analyze the CT and MRI imaging features of Kimura disease in parotid region.MethodsThis study was a cross-sectional study.From January 2018 to June 2023,a total of 40 patients with Kimura disease in parotid region who were initially diagnosed and confirmed by postoperative pathology were retrospectively collected in the Ninth People′s Hospital,School of Medicine,Shanghai Jiao Tong University.There were 36 male patients and 4 female patients,with an age of(46±19)years,ranging from 8 to 74 years old.The clinical data,preoperative CT and MRI findings were analyzed.For patients undergoing MRI examination,the apparent diffusion coefficient(ADC)value of the lesion was measured,and the type of time-signal intensity curve(TIC)was analyzed.ResultsThe ratio of male to female patients was 9∶1,with a long clinical history(1 month to 20 years).And 37 cases(37/40,92.5%)were associated with elevated peripheral blood eosinophils.Among the 40 cases,there were 4 cases of nodular type,34 cases of diffuse type,and 2 cases of intermediate type.Nodular type:All lesions were located in the superficial lobe of unilateral parotid gland,and 3 cases had multiple lesions.The lesions were round,well-defined,and homogeneous in density or signal intensity.Two lesions showed hyperintensity on T 2WI and obvious homogeneous enhancement.The TIC was plateau type,and the ADC values were 0.74×10^(-3) mm^(2)/s and 0.82×10^(-3) mm^(2)/s.Diffuse type:The 22 cases had multiple lesions,and 20 cases had subcutaneous lesions in other parts of the head and neck.The lesions were irregular in shape and ill-defined in boundary.The adjacent subcutaneous tissue and skin were involved in 33 cases.The density or signal intensity of the lesions was heterogeneous,and among the 15 patients who underwent MRI,14 cases showed uneven slightly hyperintensity with hypointense strips on T 2WI,moderate or significant enhancement.TIC showed a persistent pattern in 9 cases,and a plateau pattern in 6 cases.The ADC value was(0.99±0.21)×10^(-3) mm^(2)/s.Interm
作者
王灿
王博成
孙冰冰
张春叶
陶晓峰
朱凌
Wang Can;Wang Bocheng;Sun Bingbing;Zhang Chunye;Tao Xiaofeng;Zhu Ling(Department of Radiology,Ninth People′s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200011,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2024年第12期1402-1407,共6页
Chinese Journal of Radiology
基金
国家自然科学基金(82170975)。
