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目的探讨涎腺多形性腺瘤的MSCT表现特征对提高其术前诊断准确率的价值。方法回顾性分析本院2011年1月至2012年8月经手术病理证实的47例涎腺多形性腺瘤患者的临床表现、手术情况及MSCT影像特征。结果 47例多形性腺瘤患者中,89.4%(42/47)为单发,10.6%(5/47)为单侧多发;59.6%(28/47)位于腮腺,17.0%(8/47)位于颌下腺,14.9%(7/47)位于腭部小涎腺,8.5%(4/47)位于颊部小涎腺;术中见27.7%(13/47)病灶与周围结构有粘连,10.6%(5/47)包膜不完整,19.1%(9/47)表面扪及结节。MSCT上涎腺混合瘤多表现为边界清楚、密度均匀的圆形或类圆形肿块或结节,14.9%(7/47)病例发生囊变,其中6例位于腮腺,以术后复发及多发者最常见,颌下腺及腭部病灶均未见囊变者,增强后95.7%(45/47)表现为延迟强化(延迟180 s)。其中4例发生于硬腭者,由于其解剖结构的特殊,利用三维重组技术行MPR及VR图像后处理,不仅可提高病灶的检出,还可清晰显示病灶的部位、形态、大小及邻近骨质的改变。结论涎腺多形性腺瘤的MSCT表现具有特征性,发生于硬腭者病灶多较小,应常规应用三维重组技术显示病灶及邻近骨质的改变,提高术前诊断率。
Objective To investigate the value of MSCT features of salivary gland pleomorphic adenoma in improving the accuracy of preoperative diagnosis. Methods A retrospective analysis of 47 cases of salivary gland adenoma confirmed by surgery and pathology from January 2011 to August 2012 in our hospital was performed. The clinical manifestations, operation and MSCT imaging features were retrospectively analyzed. Results Of the 47 patients with pleomorphic adenoma, 89.4% (42/47) were single and 10.6% (5/47) were unilateral. 59.6% (28/47) were in the parotid gland and 17.0% (8/47) Located in the submandibular gland, 14.9% (7/47) in the palatal minor salivary gland, and 8.5% (4/47) in the cheek salivary gland. 27.7% (13/47) of the lesions showed adhesions to the surrounding structures and 10.6% (5/47) incomplete capsule, 19.1% (9/47) palpable nodules on the surface. In MSCT, salivary gland mixed tumor mostly showed round or oval mass or nodules with clear boundary and uniform density. Cystosis occurred in 14.9% (7/47) cases, of which 6 cases were located in the parotid gland, with postoperative recurrence and multiple The most common cystic degeneration was found in submandibular gland and palatal lesion, with 95.7% (45/47) delayed enhancement (delayed 180s) after enhancement. 4 cases occurred in the hard palate, because of its special anatomical structure, the use of three-dimensional reconstruction of MPR and VR image post-processing, not only can improve the detection of lesions, but also clearly shows the lesion location, shape, size and adjacent bone Change. Conclusions MSCT manifestation of salivary gland pleomorphic adenoma is characteristic. Most lesions occur in the soft palate. Three-dimensional reconstruction techniques should be used routinely to display the changes of lesion and adjacent bone and improve the preoperative diagnosis rate.