Niazi Masume, Mohammadzadeh Maryam, Aghazadeh Kayvan, Sharifian Hashem, Karimi Ebrahim, Shakiba Madjid, Baniasadi Maria, Rahmaty Benyamin, Adel Suzan, Moharreri Melorina
Department of Otorhinolaryngology, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Division of Neuroradiology, Department of Radiology, Amir Aalam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Int Arch Otorhinolaryngol. 2020 Apr;24(2):e160-e169. doi: 10.1055/s-0039-1697005. Epub 2019 Nov 4.
The most common site of salivary gland tumors is the parotid gland. Computed tomography (CT), magnetic resonance imaging (MRI), and sonography are imaging modalities to differentiate benign from malignant parotid tumors. The aim of this study is the evaluation of the diagnostic value of perfusion CT for differentiating histological categorization of benign and malignant parotid tumors. A total of 29 patients with parotid neoplasms were enrolled in this study. Mean age and all CT perfusion variables (gradient and permeability, blood flow [BF], blood volume [BV], mean transit time [MTT], permeability surface [PS], maximum intensity projection [MIP], time-density curve [TDC], and time to peak [TTP]) were compared among three groups (malignant tumors [MTs], Warthin's tumor [WT] and pleomorphic adenomas [PA]). The mean age of the patients was 55.9 ± 14.1 (26-77), and 15 of them were male (51.7%). Eleven lesions were PAs [37.9%], 8 lesions were WTs (27.6%0 and 10 lesions (34.5%) were MTs (6 acinic cell carcinomas [ACCs], 3 adenocystic carcinomas [AdCCs], and 1 mucoepidermoid carcinoma [MEC]). The mean age of the patients with WTs was 62 ± 7.5 years; 52 ± 14.2 for patients with Pas, and 55.2 ± 17.2 for those with MTs ( = 0.32). The mean MIP was 122.7 ± 12.2 in WT, while it was 80.5 ± 19.5 in PA, and 76.2 ± 27.1 in MTs ( < 0.001); The mean MIP for WT was higher than for PAs and MTs; the values of MTs and PAs were not statistically different. The average of BF, BV, and curve peak were higher in WTs in comparison with the other two groups, and curve time 2 and TTP were higher in PAs in comparison with MTs. Based on this study, perfusion CT of the parotid gland and its parameters can distinguish between benign and malignant parotid masses.
涎腺肿瘤最常见的发生部位是腮腺。计算机断层扫描（CT）、磁共振成像（MRI）和超声检查是区分腮腺良恶性肿瘤的影像学检查方法。 本研究的目的是评估CT灌注成像在鉴别腮腺良恶性肿瘤组织学分类中的诊断价值。 本研究共纳入29例腮腺肿瘤患者。比较了三组（恶性肿瘤[MTs]、沃辛瘤[WT]和多形性腺瘤[PA]）患者的平均年龄以及所有CT灌注参数（梯度和通透性、血流量[BF]、血容量[BV]、平均通过时间[MTT]、通透表面积[PS]、最大密度投影[MIP]、时间-密度曲线[TDC]和达峰时间[TTP]）。 患者的平均年龄为55.9±14.1岁（26 - 77岁），其中15例为男性（51.7%）。11个病灶为多形性腺瘤[37.9%]，8个病灶为沃辛瘤（27.6%），10个病灶（34.5%）为恶性肿瘤（6例腺泡细胞癌[ACCs]、3例腺样囊性癌[AdCCs]和1例黏液表皮样癌[MEC]）。沃辛瘤患者的平均年龄为62±7.5岁；多形性腺瘤患者为52±14.2岁，恶性肿瘤患者为55.2±17.2岁（P = 0.32）。沃辛瘤的平均最大密度投影（MIP）为122.7±12.2，多形性腺瘤为80.5±19.5，恶性肿瘤为76.2±27.1（P < 0.001）；沃辛瘤的平均MIP高于多形性腺瘤和恶性肿瘤；恶性肿瘤和多形性腺瘤的值无统计学差异。与其他两组相比，沃辛瘤的血流量、血容量和曲线峰值的平均值更高，与恶性肿瘤相比，多形性腺瘤的曲线时间2和达峰时间更高。 基于本研究，腮腺CT灌注成像及其参数可区分腮腺肿块的良恶性。
