Du Li-xin, Yuan Jian-peng, Guan Hong, Zhang Wei-dong, Liang Bi-ling
Department of Radiology, First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 May;30(5):1107-10.
To investigate magnetic resonance imaging (MRI) features of parotid malignant tumors and study their pathological basis.
Forty-seven patients with parotid malignant tumors confirmed by surgery (41 patients) or biopsy (6 patients) were enrolled in this study. A comparative analysis was conducted of the pathological and MRI findings in 30 patients with the entire lesions available. Each of the MRI features was analyzed retrospectively and the typical MRI findings of common parotid malignant tumors were summarized.
MRI allowed accurate diagnosis of parotid malignant tumors. Four patients with low-grade mucoepidermoid carcinoma showed well-defined tumor margin and were difficult to distinguish from benign tumors. Six patients with high-grade mucoepidermoid carcinoma had obscure margin of the tumor which easily underwent necrosis with liable lymph node involvement. The 8 cases of adenoid cystic carcinoma was characterized by extensive invasion surrounding the parotid gland. Most of 8 cases of malignant pleomorphic adenoma still showed high and heterogeneous signal on T2WI, with irregular shape and poorly defined margin. Nine cases of lymphoma all had secondary lesions characterized by extensive involvement and presence of multiple nodules. The 4 cases of acinic cell carcinoma showed either regular or irregular tumor morphology, presenting with high signal intensity on T1WI and T(2)WI.
MRI is an important modality for the diagnosis of parotid malignant tumors. Most of the common parotid malignant tumors have characteristic MRI and pathological features, which make possible their differential diagnosis.
探讨腮腺恶性肿瘤的磁共振成像(MRI)特征并研究其病理基础。
本研究纳入47例经手术(41例)或活检(6例)确诊的腮腺恶性肿瘤患者。对30例有完整病变的患者的病理和MRI表现进行对比分析。回顾性分析各项MRI特征,总结常见腮腺恶性肿瘤的典型MRI表现。
MRI能够准确诊断腮腺恶性肿瘤。4例低级别黏液表皮样癌肿瘤边界清晰,难以与良性肿瘤区分。6例高级别黏液表皮样癌肿瘤边界不清,易发生坏死且易累及淋巴结。8例腺样囊性癌的特征是对腮腺周围组织有广泛侵犯。8例恶性多形性腺瘤中的大多数在T2WI上仍表现为高信号且不均匀,形态不规则,边界不清。9例淋巴瘤均有继发性病变,表现为广泛受累及多个结节。4例腺泡细胞癌肿瘤形态规则或不规则,在T1WI和T2WI上呈高信号强度。
MRI是诊断腮腺恶性肿瘤的重要手段。大多数常见腮腺恶性肿瘤具有特征性的MRI和病理特征,使其鉴别诊断成为可能。