12例Warthin瘤样黏液表皮样癌影像学分析

doi:10.19439/j.sjos.2024.02.020

摘要/Abstract

摘要： 目的: 总结Warthin瘤样黏液表皮样癌（Warthin-like mucoepidermoid carcinoma, WT-MEC）的超声、CT和MRI表现,探讨其影像学特点,为临床术前诊断提供参考。方法: 收集2017年1月—2021年12月上海交通大学医学院附属第九人民医院收治的12例经病理明确诊断的WT-MEC患者的临床信息和超声、CT、MRI资料,回顾性总结其具体特征。结果: 12例WT-MEC患者中,男7例,女5例,平均年龄为（42.7±16）岁。7例行超声检查,6例行CT检查,2例行MRI检查。所有肿瘤均表现为腮腺内单发肿块。91.7%(11/12)的病灶（91.7%）边界清晰,83.3%（10/12）的病灶呈囊实性肿块。在超声上,71.4%（5/7）的病变表现为囊实性混合回声、85.7%（6/7）血流不丰富、85.7%（6/7）后方回声增强。在CT上,所有病变（6/6,100%）呈软组织密度肿块,不均匀强化（5/6,83.3%）。在MRI上,肿瘤在平扫T1WI呈低信号或等信号,T2WI呈高信号,增强T1WI呈不均匀强化。结论: WT-MEC多表现为单发、边界清晰、无钙化的囊实性肿块。肿瘤内多发、大小不等的囊性部分是其影像学特征。

关键词: Warthin瘤样黏液表皮样癌, 腮腺, 超声, CT, MRI

Abstract: PURPOSE: To summarize the ultrasound, CT and MRI manifestations of Warthin-like mucoepidermoid carcinoma (WT-MEC), and to explore its imaging characteristics, so as to provide reference for clinical and preoperative diagnosis. METHODS: The clinical information and imaging data of ultrasound, CT and MRI of 12 patients with WT-MEC diagnosed by pathology in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2017 to December 2021 were collected, and their specific characteristics were retrospectively summarized. RESULTS: Among the 12 WT-MEC patients, there were 7 males and 5 females, with an average age of (42.7±16) years. Seven cases underwent ultrasound examination, 6 cases underwent CT examination, and 2 cases underwent MRI examination. Radiologically, all the lesions presented as a solitary mass. 11/12 lesions(91.7%) were identified as well-defined margins, and 10/12(83.3%) as solid-cystic masses. All solid-cystic lesions contained multiple cystic areas with variable sizes. On US images, most lesions showed mixed-echoic echogenicity(5/7, 71.4%), poor vascularization (6/7, 85.7%) and acoustic enhancement (6/7, 85.7%). CT revealed all the lesions (6/6, 100%) as a soft-tissue mass with heterogeneous enhancement (5/6, 83.3%). MRI imaging demonstrated the neoplasm with low or iso-signal intensity on plain T1WI and hyperintensity on T2WI. The heterogeneous enhancement was shown on contrast-enhanced T1WI. CONCLUSIONS: Most WT-MECs represent as a solitary, well-defined, solid-cystic mass in the parotid gland. The neoplasm may be characterized by the multiple and variable-sized cystic components within the tumor.

Key words: Warthin-like mucoepidermoid carcinoma, Parotid gland, Ultrasound, Computed tomography, Magnetic resonance imaging

中图分类号:

R739.8

陈倩倩, 余强, 孙晶晶, 熊屏. 12例Warthin瘤样黏液表皮样癌影像学分析[J]. 上海口腔医学, 2024, 33(2): 219-224.

CHEN Qian-qian, YU Qiang, SUN Jing-jing, XIONG Ping. Imaging findings in 12 cases of Warthin-like mucoepidermoid carcinoma[J]. Shanghai Journal of Stomatology, 2024, 33(2): 219-224.

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