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目的分析腮腺结核病的CT征象,提高对该病的认识与诊断水平。方法搜集2009年8月-2012年12月期间经手术病理及实验室检查证实的腮腺结核病患者9例,回顾性分析其CT表现并与病理检查结果对照。结果 9例患者均单侧发病,其中左侧7例,右侧2例。腮腺淋巴结结核病8例,均位于浅叶,3例单发,5例多发,共30枚病灶,直径约0.5~4.5 cm;平扫呈均匀稍低密度,增强后呈中等密度均匀实性强化25枚,环状强化4枚,花边状强化1枚,其中6例临近颈阔肌、皮下脂肪及皮肤不同程度增厚,6例伴颈部淋巴结增大。腮腺实质结核病1例,为弥漫性实质受累,累及深浅叶,平扫呈不均匀稍低密度,内见斑片状低密度影及结节状钙化灶,增强后整个腮腺实质弥漫性强化,局部见不规则液化、坏死,临近颈阔肌及脂肪层稍肿胀,不伴颈部淋巴结增大。结论腮腺结核病的CT征象与其病理改变密切相关,对于单侧腮腺浅叶占位病变,呈均匀实性强化、环状强化或花边状强化,临近颈阔肌、皮肤及皮下脂肪层增厚,伴颈部淋巴结增大,应考虑到腮腺淋巴结结核病的诊断。
Objective To analyze the CT signs of parotid tuberculosis and improve the level of understanding and diagnosis of the disease. Methods Nine patients with parotid tuberculosis confirmed by surgery, pathology and laboratory tests from August 2009 to December 2012 were collected. Their CT findings were retrospectively analyzed and compared with the results of pathological examination. Results All the 9 patients had unilateral disease, including 7 cases on the left and 2 cases on the right. Parotid lymph node tuberculosis in 8 cases, all located in the shallow leaves, 3 cases of single, 5 cases of multiple, a total of 30 lesions, a diameter of about 0.5 ~ 4.5 cm; plain uniform slightly lower density, enhanced after the medium-density uniform strengthening 25 Four rings were reinforced and one was lace-like. Six of them were adjacent to the platysma, and subcutaneous fat and skin were thickened to varying degrees. Six cases were accompanied with enlarged cervical lymph nodes. Parotid parenchymal tuberculosis in 1 case, diffuse substantial involvement, involving the depth of the leaves, uneven scan was slightly lower density, see the patchy low density and nodular calcification within the enhanced parotid parenchyma enhanced diffuse local See irregular liquefaction, necrosis, near the platysma and fat layer slightly swollen, not accompanied by cervical lymph nodes increased. Conclusions The CT signs of parotid tuberculosis are closely related to the pathological changes. For unilateral parotid gland lesions in the parietal lobe, they are uniformly solidified, with ring-like enhancement or lace-like enhancement. The adjacent platysma, thickening of the skin and subcutaneous fat layer, with Neck lymph nodes increased, should be considered parotid lymph node tuberculosis diagnosis.