64排螺旋CT常规及增强检查在涎腺占位性病变的诊断和鉴别诊断中的临床意义(1)
【摘要】 目的：探讨64排螺旋CT常规及增强检查在涎腺占位性病变的诊断和鉴别诊断中的临床意义。方法：选取2015年8月-2019年8月笔者所在医院收治的涎腺肿瘤患者69例。对所有患者行64排螺旋CT常规及增强检查，对比不同组织的影像学参数。结果：平扫可见涎腺肿瘤病灶均为等密度或低密度影，不同肿瘤间的CT值差异无统计学意义(P>0.05)。进行双期增强扫描可见，多形性腺瘤动脉期无强化或轻度强化，静脉期强化程度高于动脉期;腺淋巴瘤呈“快进快出”的强化特征;基底细胞瘤动脉期和静脉期均有显著强化;肌上皮瘤动、静脉期均有轻度强化;黏液表皮样癌、腮腺细胞癌和涎腺导管癌等恶性肿瘤则为延迟显著渐进强化特点。在动脉期，腺淋巴瘤的CT值明显高于其他肿瘤，在静脉期，则恶性肿瘤的CT值最高，差异均有统计学意义(P<0.05)。结论：在64排螺旋CT的基础上增强扫描，不同病理分型肿瘤具有各自显著特征，该技术还能通过机体血流动力学相关指标对涎腺肿瘤的良、恶性加以鉴别诊断，具有一定临床价值。
【关键词】 64排螺旋CT 增强扫描 涎腺 肿瘤
[Abstract] Objective： To explore the clinical significance of 64 slice spiral CT routine and enhanced scan in the diagnosis and differential diagnosis of salivary gland space occupying lesions. Method： From August 2015 to August 2019， 69 patients with salivary gland tumor were selected. All patients were examined with 64 slice spiral CT routine and enhanced scan， and the imaging parameters of different tissues were compared. Result： On plain scan， the lesions of salivary gland tumors were isodense or hypodense， there was no significant difference in CT value between different tumors (P>0.05). Double phase contrast-enhanced scan showed that pleomorphic adenoma had no or slight enhancement in arterial phase， and the enhancement degree in venous phase was higher than that in arterial phase; adenolymphoma had the characteristics of “fast in and fast out”; basal cell tumor had significant enhancement in arterial phase and venous phase; myoepithelioma had slight enhancement in arterial and venous phase; mucoepidermoid carcinoma， parotid cell carcinoma， salivary duct carcinoma and other malignant tumors were characterized by delayed and progressive enhancement. In arterial phase， the CT value of adenolymphoma was significantly higher than that of other tumors. In venous phase， the CT value of malignant tumors was the highest， the differences were statistically significant (P<0.05). Conclusion： On the basis of 64 slice spiral CT， enhanced scan can show their own significant characteristics of different pathological types of tumors. This technology can also differentiate the benign and malignant salivary gland tumors through the related indexes of hemodynamics， which has a certain clinical value.
涎腺包括腮腺、頜下腺、舌下腺三对大涎腺及散布在口腔黏膜下的许多小涎腺[1]。肿瘤是涎腺组织中最常见的疾病，其中绝大多数是上皮性肿瘤，由于涎腺上皮性肿瘤的病理类型复杂、形态多变，不同类型的肿瘤在临床表现、影像学表现、治疗和预后等方面均不相同[2]。常规的影像学检查仅可确定病灶的部位、大小、范围，但在鉴别涎腺肿瘤良、恶性方面易受到检查者主观性因素的影响，准确率较低。故探寻一种行之有效的影像学诊断方法具有重要意义[3]。本研究选取2015年8月-2019年8月笔者所在医院收治的涎腺肿瘤患者69例，以探讨64排螺旋CT常规及增强扫描在涎腺占位性病变的诊断和鉴别诊断的临床意义，现报道如下。, 百拇医药(陈巍岚 马兴灿 郭作梁)
【关键词】 64排螺旋CT 增强扫描 涎腺 肿瘤
[Abstract] Objective： To explore the clinical significance of 64 slice spiral CT routine and enhanced scan in the diagnosis and differential diagnosis of salivary gland space occupying lesions. Method： From August 2015 to August 2019， 69 patients with salivary gland tumor were selected. All patients were examined with 64 slice spiral CT routine and enhanced scan， and the imaging parameters of different tissues were compared. Result： On plain scan， the lesions of salivary gland tumors were isodense or hypodense， there was no significant difference in CT value between different tumors (P>0.05). Double phase contrast-enhanced scan showed that pleomorphic adenoma had no or slight enhancement in arterial phase， and the enhancement degree in venous phase was higher than that in arterial phase; adenolymphoma had the characteristics of “fast in and fast out”; basal cell tumor had significant enhancement in arterial phase and venous phase; myoepithelioma had slight enhancement in arterial and venous phase; mucoepidermoid carcinoma， parotid cell carcinoma， salivary duct carcinoma and other malignant tumors were characterized by delayed and progressive enhancement. In arterial phase， the CT value of adenolymphoma was significantly higher than that of other tumors. In venous phase， the CT value of malignant tumors was the highest， the differences were statistically significant (P<0.05). Conclusion： On the basis of 64 slice spiral CT， enhanced scan can show their own significant characteristics of different pathological types of tumors. This technology can also differentiate the benign and malignant salivary gland tumors through the related indexes of hemodynamics， which has a certain clinical value.
涎腺包括腮腺、頜下腺、舌下腺三对大涎腺及散布在口腔黏膜下的许多小涎腺[1]。肿瘤是涎腺组织中最常见的疾病，其中绝大多数是上皮性肿瘤，由于涎腺上皮性肿瘤的病理类型复杂、形态多变，不同类型的肿瘤在临床表现、影像学表现、治疗和预后等方面均不相同[2]。常规的影像学检查仅可确定病灶的部位、大小、范围，但在鉴别涎腺肿瘤良、恶性方面易受到检查者主观性因素的影响，准确率较低。故探寻一种行之有效的影像学诊断方法具有重要意义[3]。本研究选取2015年8月-2019年8月笔者所在医院收治的涎腺肿瘤患者69例，以探讨64排螺旋CT常规及增强扫描在涎腺占位性病变的诊断和鉴别诊断的临床意义，现报道如下。, 百拇医药(陈巍岚 马兴灿 郭作梁)
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