CAJ | 학술논문

目的：探讨腮腺恶性肿瘤的临床及影像表现。方法回顾性分析经临床病理证实的50例腮腺恶性肿瘤的临床资料，并对其中有影像资料的18例患者（3例超声，3例CT，3例MRI，6例行CT及超声，2例行MRI及超声，1例行CT和MRI）肿瘤位置、形态、大小、边界、内部结构、强化或血流情况等特征进行分析。结果18例腮腺恶性肿瘤表现为腮腺区结节或肿块，无痛性肿块16例，疼痛2例。肿块类圆形或椭圆形13例，肿块为实性16例，囊实性2例。部分不规则，边界清楚10例、不清晰8例。肿块可跨深浅叶（8例），可位于浅叶（10例）。单发17例，1例淋巴瘤多发。肿块多强化明显或血流丰富（15例）。肿块大小范围较大。肿块多有分叶征（15例）。转移瘤多发、常囊变坏死、边界不清。恶性淋巴瘤常多发、均质、边界清。结论腮腺恶性肿瘤有一定影像特征，但同良性肿瘤特征有重叠；合并淋巴结转移、肿瘤分叶且边界不清或侵犯周围结构、明显强化且不均匀或伴明显坏死等对腮腺恶性肿瘤的诊断有重要价值。
목적：탐토시선악성종류적림상급영상표현。방법회고성분석경림상병리증실적50례시선악성종류적림상자료，병대기중유영상자료적18례환자（3례초성，3례CT，3례MRI，6례행CT급초성，2례행MRI급초성，1례행CT화MRI）종류위치、형태、대소、변계、내부결구、강화혹혈류정황등특정진행분석。결과18례시선악성종류표현위시선구결절혹종괴，무통성종괴16례，동통2례。종괴류원형혹타원형13례，종괴위실성16례，낭실성2례。부분불규칙，변계청초10례、불청석8례。종괴가과심천협（8례），가위우천협（10례）。단발17례，1례림파류다발。종괴다강화명현혹혈류봉부（15례）。종괴대소범위교대。종괴다유분협정（15례）。전이류다발、상낭변배사、변계불청。악성림파류상다발、균질、변계청。결론시선악성종류유일정영상특정，단동량성종류특정유중첩；합병림파결전이、종류분협차변계불청혹침범주위결구、명현강화차불균균혹반명현배사등대시선악성종류적진단유중요개치。
Objective To evaluate the clinical and imaging features of malignant tumors of the parotid gland.Methods The clinical information of 50 patients with histologically confirmed malignant tumors of the parotid glands and the imaging studies in 18 of these patients(3 US,3 CT,3 MRI,6 CT and US,2 US and MRI,1 CT and MRI)were reviewed.The location,shape,size, border,internal architecture,blood flow and contrast enhancement of the 18 tumors were analyzed.Results The 18 tumors were painless(16)or painful(2),solid(16)or complex(2)masses with round/oval(13)or irregular(5)shapes,well-defined(10)or ill-defined(8)borders,located in the superficial lobe(10),or in both deep and superficial lobes(8).17/18 tumors were solitary and 1 case of lymphoma was multicentric.The tumors were mainly multilobular with significant contrast enhancement or abundant blood flow (15/18).The metastases were often multiple with necrosis and ill-defined borders.The one case of lymphoma presented as multiple heterogeneous well-defined masses.Conclusion The imaging features of malignant and benign parotid gland tumors overlap. Multilobularity with ill-defined borders,marked heterogeneous contrast enhancement,necrosis,invasion of surrounding structures, and lymph node metastasis can aid diagnosis of malignancy.