原发性腮腺淋巴瘤的MR表现与病理对照研究
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腮腺腺淋巴瘤的MRI表现发表时间:2016-06-21T16:26:58.143Z 来源:《航空军医》2016年第8期作者:蒋书情周海军陈林凯黄海华[导读] 总结腮腺腺淋巴瘤在磁共振成像方式下表现出现特征。
南华大学附属郴州市第一人民医院 423000 【摘要】目的:总结腮腺腺淋巴瘤在磁共振成像方式下表现出现特征。
方法:回顾性分析30名经病理学检查确认为腮腺腺淋巴瘤病人的临床及MRI表现,结果:13例单发,17 例多发,共51个病灶,图像显示病灶形态为类圆形 36个,呈现分叶有14个,其他形态有1个,其边缘清楚 45个,边缘模糊 6个。
T 1 WI 显示为信号均匀有4个病灶,T 1 WI 均显示信号不均匀有47个病灶。
所有病灶的T 2 WI 和FSE T2 WI 脂肪抑制序列均表现出不均匀的信号。
增强扫描后发现轻度强化有16个病灶,占总数的31.4%;中度强化 16个病灶,占总数的31.4%;明显强化 19个病灶,占总数的37.2%。
结论:发现腮腺腺淋巴瘤主要发在腮腺的后下象限中,体形态学特征为良性肿瘤,平扫各序列的信号也具有一定的相似性。
【关键词】腮腺腺淋巴瘤;MRI;成像特点【Abstract】Objective:To summarize the parotid lymphoma magnetic resonance imaging manifestations characteristic manner.Methods:A retrospective analysis of 30 confirmed by pathological examination and MRI parotid lymphoma patients,the results:13 patients with solitary,17 multiple,51 lesions,lesions form as an image display round 36,presented leaf 14,there is one other form,its clear edge 45,edge blur 6.T 1 WI signal appears as a uniform has four lesions,T 1 WI showed inhomogeneous signal 47 lesions.All lesions T 2 WI and FSE T 2 WI with fat suppression exhibited uneven signal.Enhanced scan showed mild enhancement after 16 lesions,accounting for 29.4% of the total;moderately enhanced 16 lesions,accounting for 29.4% of the total;significantly enhanced 19 lesions,accounting for 41.2% of the total..Conclusion:parotid lymphoma found primarily issued in the quadrant of the parotid gland,benign morphological characteristics,each scan signal sequence also has a certain similarity.【Key words】parotid lymphoma;MRI;Imaging Features临床发现腮腺腺淋巴瘤是临床上常见的良性肿瘤,其表现的特点为腮腺腺淋巴瘤病灶较多,且好发于病人双侧腮腺后侧,虽然淋巴瘤可以手术切除治疗,但是由于其病灶较多且部分患者病灶分散,直接提高根治性手术的难度。
腮腺腺淋巴瘤的MRI表现特征分析目的探讨腮腺腺淋巴瘤在不同MRI成像方式上的影像学特点,从而为疾病的诊断和鉴别提供依据。
方法回顾性分析2013年1月~2017年12月我院收治的50例腮腺腺淋巴瘤患者的临床资料。
比较50例腮腺腺淋巴瘤患者在常规MRI、动态扫描增强(DCE-MRI)以及磁共振扩散加权成像(DWI)等不同磁共振成像方法上的表现特征。
结果50例患者共67个病灶,其中单侧单发24例,单侧多发6例,双侧多发20例。
67个腮腺腺淋巴瘤病灶中,其中45个病灶以实性病灶为主,呈现较为均匀的长T1、长T2信号,22个病灶存在囊变区,囊变区信号表现多样。
19例患者接受DCE-MRI检查,结果显示,41个病灶中37个病灶为快速强化、快速廓清型强化模式,4个为快速强化、缓慢廓清型强化模式。
结论综合结合多种MRI成像方法,可提高对腮腺腺淋巴瘤诊断的敏感性,有利于疾病的诊断和鉴别诊断,具有积极的临床应用价值。
[Abstract]Objective To investigate the distinct MRI characteristics of parotid lymphoma,and provide the basis for the diagnosis and treatment of parotid lymphoma.Methods The clinical data of 50 patients with parotid lymphoma treated from January 2013 to December 2017 in our hospital was selected.The manifestation characteristics based on the conventional MRI,dynamic contrast enhancement-MRI (DCE-MRI)and diffusion weighted imaging (DWI)were compared.Results A total of 67 lesions were observed in the 50 patients,including 24 unilateral and single cases,6 unilateral and multiple cases,and 20 multi-lateral and multiple cases.For 67 parotid lymphoma lesions,there were 45 solid lesions with uniform high T1 and high T2 signal intensity and 22 cystic lesions with diversified signal intensity.A total of 19 patients with 41 leisions received the DCE-MRI examination,37 cases with rapid enhancement and rapid washout enhancement,4 cases with srapid enhancement and slow washout enhancement were observed.Conclusion The combined examination methods of the distinct MRI characteristics can positively improve the diagnosis sensitivity,and make for the clinical diagnosis and differential diagnosis of parotid lymphoma,which has positive clinical application value.[Key words]Parotid lymphoma;Magnetic resonance imaging;Dynamic contrast enhancement MRI;Imaging characteristics磁共振成像(magnetic resonance imaging,MRI)是臨床常用的疾病诊断方式。
腮腺腺淋巴瘤的CT、MRI表现特征张镇滔;郑晓林;张旭升;袁灼彬【摘要】目的:探讨腮腺腺淋巴瘤的临床及CT、MRI表现特征。
方法:回顾性分析经组织病理学证实的24例腮腺腺淋巴瘤患者的临床及CT、MRI表现特点,着重观察其部位、大小、形态、边缘、CT密度或 MRI信号、强化形式等。
结果:24例均为中老年男性,20例有嗜烟史。
24例CT和 MRI共发现56个病灶,其中单发9例,多发15例。
49个病灶位于腮腺浅叶,7个病灶跨叶,32个病灶位于腮腺浅叶后下极。
病灶长径0.3~4.6 cm,平均长径约2.9 cm。
53个病灶包膜完整,边缘清楚。
30个病灶呈实性,26个呈囊实性,囊变区呈裂隙状或分隔状。
实性部分CT表现为密度均匀肿块,增强多呈中度至明显强化。
MRI平扫病灶信号均匀或不均匀,T1 WI 呈等或稍低信号,T2 WI 呈稍高信号。
增强多呈早期明显强化、延迟期强化减低。
部分病灶可见血管包绕或小血管穿行,邻近下颌后静脉受压推移。
结论:腮腺腺淋巴瘤的临床和CT、MRI表现具有一定特征性,分析其CT和 MRI表现并结合临床资料,可为诊断提供重要参考。
%Objective:To evaluate the clincal,CT and MRI characteristics of parotid adenolymphoma so as to promote our understanding of the disease.Methods :Twenty-four patients with parotid adenolymphoma verified by histopathology were collected.The clincal,CT and MRI features were retrospectively analysed,and position,size,shape,margin,density, signal intensity and enhancing patterns were mainly observed.Results:All 24 patients were males and had smoking hobby. Fifty-six lesions in 24 patients were detected by CT or MRI,among which single lesion in 9 cases and multiple lesions in 15 cases.Forty-nine lesions were located in parotid superficiallobes.The long diameter of lesions was 0.3~4.6cm,with a mean of2.9cm.Fifty-three lesions had intact capsule and showed well-defined margins.Thirty lesions were solid,26 lesions were cystic solid and the cysts manifested as crannied and septate.The solid parts on CT had homogeneous density and were moderately or intensively enhanced after injecting contrast medium.plain scan of MRI showed homogeneous or unhomoge-neous,iso-intense or mildly low signals on T1 WI and mildly high signals on T2 WI.They were obviously enhanced in early phases and slightly enhanced in delayed phases.Some lesions were surrounded or traversed by small vessels.The neighbor-ing retro mandibular vein were compressed.Conclusions:Parotid adenolymphoma possesses certain characteristics on CT and MRI images,which,through analysis and in combination with clincal manifestations,can be valuable in the diagnosis of this disease.【期刊名称】《放射学实践》【年(卷),期】2014(000)005【总页数】4页(P529-532)【关键词】腮腺;腺淋巴瘤;体层摄影术,X线计算机;磁共振成像【作者】张镇滔;郑晓林;张旭升;袁灼彬【作者单位】523000 广东,东莞市人民医院放射科;523000 广东,东莞市人民医院放射科;523000 广东,东莞市人民医院放射科;523000 广东,东莞市人民医院放射科【正文语种】中文【中图分类】R739.81;R445.2;R814.42腮腺腺淋巴瘤又称Warthin瘤或乳头状淋巴囊腺瘤,是涎腺较为常见的良性肿瘤,绝大多数发生于腮腺,约占腮腺上皮性肿瘤的15.3%,占良性肿瘤的20.6%[l-2],其发病率仅次于多形性腺瘤,位居第二位,并有逐渐上升的趋势。