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目的探讨CT对涎腺良恶性病变鉴别诊断的价值。方法回顾性分析经手术病理证实(个别经穿刺细胞学证实)的涎腺良恶性病变36例,其中良性肿瘤19例,慢性炎症5例,结核1例,恶性肿瘤11例,从形态、密度、边缘、皮肤是否受累及颈淋巴结有无肿大等方面分析其CT表现。结果良性肿瘤大多形态规则(17/19),边缘清晰锐利(16/19),与周围组织分界清楚,慢性炎症轮廓较规则,但边缘模糊,增强扫描强化程度不一。恶性肿瘤CT多表现为形态不规则(7/11),边缘模糊,与周围组织分界不清,相邻的脂肪间隙模糊、消失,皮下脂肪层受侵,表皮线样影消失。部分病例(3/11)表现为涎腺弥漫性增大而形成“铸型”。大多数良性病变和恶性肿瘤的密度均表现为密度不均匀甚至是大范围的囊变、坏死。结论CT对涎腺良恶性病变的鉴别诊断具有很高的价值。
Objective To investigate the value of CT in the differential diagnosis of benign and malignant salivary glands. Methods Thirty - six cases of benign and malignant lesions of salivary gland, including benign tumors, 5 cases of chronic inflammation, 1 case of tuberculosis and 11 cases of malignant tumors, were retrospectively analyzed by pathology. Edge, whether the skin involvement and cervical lymph nodes with or without swelling and other aspects of its CT performance. Results Most of the benign tumors had regular morphology (17/19), sharp and sharp edges (16/19), clear boundaries with surrounding tissues, and regular outline of chronic inflammation. However, the edges were blurred and the degree of enhanced enhancement enhanced. Malignant tumors showed morphological irregularities (7/11), with blurred edges and unclear boundaries with the surrounding tissues. The adjacent fat gaps were blurred and disappeared, subcutaneous fat layers were invaded and epidermal line-like signs disappeared. In some cases (3/11) showed diffuse increased salivary gland to form a “cast.” The density of most benign and malignant tumors is manifested as uneven density and even a wide range of cystic degeneration and necrosis. Conclusion CT is of great value in the differential diagnosis of benign and malignant salivary glands.