19例腮腺腺泡细胞癌的MRI影像表现分析

doi:10.19439/j.sjos.2022.03.020

上海口腔医学 ›› 2022, Vol. 31 ›› Issue (3): 322-326.doi: 10.19439/j.sjos.2022.03.020

19例腮腺腺泡细胞癌的MRI影像表现分析

肖华, 陶晓峰, 朱文静^*, 陈倩倩^*

上海交通大学医学院附属第九人民医院放射科,上海 200011

收稿日期:2022-01-17 修回日期:2022-03-01 出版日期:2022-06-25 发布日期:2022-07-07
通讯作者: 朱文静,E-mail：amanda_1983_328@163.com;陈倩倩,E-mail：chenqianqian0902@163.com。^*共同通信作者
作者简介:肖华（1986-）,女,硕士,住院医师,E-mail：jo.xiao@qq.com
基金资助:
国家自然科学基金（91859202、81771901）

MRI findings of parotid acinic cell carcinoma in 19 consecutive cases

XIAO Hua, TAO Xiao-feng, ZHU Wen-jing, CHEN Qian-qian

Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2022-01-17 Revised:2022-03-01 Online:2022-06-25 Published:2022-07-07

摘要/Abstract

摘要： 目的: 总结腮腺腺泡细胞癌（acinar cell carcinoma,AciCC）的MRI特征,探讨MR功能成像的诊断价值。方法: 分析269例经手术病理证实的颌面部AciCC的临床资料。其中,19例腮腺AciCC行术前MRI检查（1例平扫,18例增强）,17例行DWI扫描, 15例行DCE扫描。回顾分析19例患者的MRI表现,分析病灶大小、部位、形态、边缘、内部结构、强化方式及功能成像特点。采用SPSS 25.0软件包对数据进行统计学分析。结果: 269例颌面部AciCC中,男108例,女161例,男∶女=1∶1.49。年龄4~89岁,平均年龄（45.95±17.33）岁。84.4%（227/269）的发病部位位于腮腺。MRI表现为78.9%（15/19）病变边界清晰,57.9%（11/19）呈圆形或椭圆形,36.8%（7/19）呈分叶状结节。1例病变形态不规则,且侵犯外周。病灶最大径6~56 mm,平均（24.8±15.3） mm。内部结构为57.9%（11/19）呈囊实性,42.1%（8/19）呈实性,31.6%（6/19）有出血。T2加权像52.6%（10/19）可见包膜结构,15.8%（3/19）内部见低信号分隔;38.9%（7/18）强化均匀,61.1%（11/18）强化不均匀。功能成像显示肿瘤平均ADC值为（1.026±0.194）×10^-3 mm²/s（n=17）,86.7%（13/15）TIC为Ⅱ型。结论: 绝大部分颌面部AciCC位于腮腺。常规MRI显示,AciCC形态学上与良性肿瘤较难鉴别。功能成像ADC值较良性肿瘤低,TIC曲线类型多为Ⅱ型。将形态学与功能成像相结合,可提高该病的诊断准确率。

关键词: 腮腺, 腺泡细胞癌, 磁共振成像, 功能成像

Abstract: PURPOSE: To describe the MRI features of acinar cell carcinoma of parotid gland (AciCC) and to evaluate the diagnostic value of MR functional imaging. METHODS: A total of 269 cases of maxillofacial AciCC confirmed by surgery and pathology were analyzed. Among them, nineteen subjects with AciCC in the parotid gland underwent preoperative MRI examination (non-enhanced scan for one case, enhanced scan for 18 cases), seventeen patients underwent diffusion-weighted imaging scan, and 15 patients underwent dynamic contrast-enhanced scan. MRI findings of 19 patients were retrospectively analyzed. The lesion size, location, morphology, margin, internal composition, enhancement pattern and functional imaging characteristics were analyzed. SPSS 25.0 software package was used for statistical analysis. RESULTS: Among 269 cases of maxillofacial AciCC, there were 108 males and 161 females, male: female = 1:1.49, aged from 4 to 89 years, with a mean age of (45.95±17.33) years. 84.4% (227/269) were located in the parotid gland. On MRI images, 78.9% (15/19) had well-defined margin, 57.9% (11/19) were round or oval, and 36.8% (7/19) were lobed nodules. One case had irregular morphology and peripheral invasion. The range of maximum diameter was 6-56 mm, averaging (24.8±15.3) mm. Internal composition showed 57.9% (11/19) were cystic solid, 42.1% (8/19) were solid, 31.6% (6/19) had bleeding. T2-weighted MRI showed 52.6% (10/19) with envelope structure, 15.8% (3/19) with low signal separation inside, 38.9%(7/18) had uniform enhancement, and 61.1%(11/18) had uneven enhancement. Functional imaging showed the mean ADC value of tumor was (1.026±0.194)×10^-3 mm²/s(n=17). 86.7%(13/15) TIC was type Ⅱ. CONCLUSIONS: Most maxillofacial AciCC are located in the parotid gland. It is difficult to distinguish AciCC from benign tumors with conventional MRI in morphology. The ADC value of AciCC is lower than that of benign tumors, and the type of TIC curve is mostly type Ⅱ. Combination of morphology and functional imaging can improve the diagnostic accuracy of this disease.

Key words: Parotid gland, Acinic cell carcinoma, Magnetic resonance image, Functional imaging

中图分类号:

R739.8

肖华, 陶晓峰, 朱文静, 陈倩倩. 19例腮腺腺泡细胞癌的MRI影像表现分析[J]. 上海口腔医学, 2022, 31(3): 322-326.

XIAO Hua, TAO Xiao-feng, ZHU Wen-jing, CHEN Qian-qian. MRI findings of parotid acinic cell carcinoma in 19 consecutive cases[J]. Shanghai Journal of Stomatology, 2022, 31(3): 322-326.

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19例腮腺腺泡细胞癌的MRI影像表现分析

MRI findings of parotid acinic cell carcinoma in 19 consecutive cases

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