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目的 :探讨MRI征象在涎腺肿瘤鉴别诊断中的价值。方法 :回顾性分析经病理证实的108例涎腺肿瘤116个瘤灶的MRI表现,116个瘤灶中良性肿瘤98个,恶性肿瘤18个。观察病灶的部位、形态、边界、MR信号、强化类型、均匀性、邻近组织的浸润及颈部淋巴结情况,并与病理结果进行对照,分析不同类型涎腺肿瘤间MR征象的差异。结果:涎腺良性肿瘤的MRI表现:形态规则(71/98)、边界清楚(66/98)。所有52个多形性腺瘤T2WI表现为高信号并呈延迟强化,32个腺淋巴瘤增强后均呈中度强化,其中18个病灶T2WI表现为等信号。涎腺恶性肿瘤的MRI表现:5个黏液表皮样癌中,3个中、低度恶性者呈囊实性,边界较清晰,2个中、高度恶性者呈实性,边界不清;3个腺样囊性癌中,2个以侵犯范围广泛为特征;4个腺泡细胞癌中,1个低度恶性者与良性肿瘤较难区分,1个肿瘤直径>3 cm,表现出明显浸润性生长特点;2个淋巴上皮癌呈实性,增强后中度强化;恶性多形性腺瘤(1个)表现为同时具有良性和恶性肿瘤的特点;鳞癌(1个)表现为形态不规则、蟹足样浸润;淋巴瘤(1个)和淋巴结转移瘤(1个)表现为腮腺结节合并颈部多发淋巴结肿大,结节信号与颈部肿大淋巴结一致。结论:常见涎腺良、恶性肿瘤MRI表现各有特点,对大多数病例进行鉴别诊断是可行的。
Objective: To investigate the value of MRI in the differential diagnosis of salivary gland tumors. Methods: The MRI findings of 116 tumors confirmed by pathology in 108 cases of salivary gland tumors were retrospectively analyzed. There were 98 benign tumors in 116 tumors and 18 malignant tumors. The lesion’s location, morphology, border, MR signal, enhancement type, homogeneity, adjacent tissue infiltration and cervical lymph nodes were observed and compared with the pathological results to analyze the difference of MR signs between salivary gland tumors of different types. Results: The MRI findings of salivary gland benign tumors: morphology (71/98), clear boundary (66/98). All 52 pleomorphic adenoma T2WI showed high signal and delayed enhancement, 32 adenocarcinoma enhanced moderate enhancement, of which 18 lesions T2WI showed equal signal. MRI findings of salivary gland malignant tumors: Among the 5 mucoepidermoid carcinomas, 3 of them were moderate and low malignant with cystic solidity and the border was clearer. The two middle and high malignant tumors showed solidity with unclear boundary. Three Adenoid cystic carcinoma, 2 were characterized by a wide range of violations; 4 acinar cell carcinoma, a low degree of malignancy and benign tumors more difficult to distinguish a tumor diameter> 3 cm, showed significant invasiveness (1) showed the characteristics of both benign and malignant tumors; squamous cell carcinoma (1) showed morphological irregularity, Crab foot-like infiltration; lymphoma (1) and lymph node metastases (1) showed parotid nodules with multiple neck lymph nodes, nodules signal consistent with enlarged neck lymph nodes. Conclusion: MRI findings of common salivary gland benign and malignant tumors have their own characteristics. It is feasible to make differential diagnosis in most cases.