腮腺基底细胞腺瘤MRI特征与病理对照分析

doi:10.19401/j.cnki.1007-3639.2017.12.003

中国癌症杂志 ›› 2017, Vol. 27 ›› Issue (12): 935-939.doi: 10.19401/j.cnki.1007-3639.2017.12.003

腮腺基底细胞腺瘤MRI特征与病理对照分析

何慕真¹，张盛箭²，马明平¹，黄海建³

1. 福建医科大学省立临床学院，福建省立医院放射科，福建福州 350000 ；
2. 复旦大学附属肿瘤医院放射诊断科，复旦大学上海医学院肿瘤学系，上海 200032 ；
3. 福建医科大学省立临床学院，福建省立医院病理科，福建福州 350000

出版日期:2017-12-30 发布日期:2018-01-11
通信作者: 张盛箭 E-mail：zhangshengjian@yeah.net

MRI features of basal cell adenoma of the parotid gland and its correlation with pathology

HE Muzhen¹, ZHANG Shengjian², MA Mingping¹, HUANG Haijian³

1. Provincial Clinical College, Fujian Medical University, Department of Radiology, Fujian Provincial Hospital, Fuzhou 350000, Fujian Province, China; 2.Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 3. Provincial Clinical College, Fujian Medical University and Department of Pathology, Fujian Provincial Hospital, Fuzhou 350000, Fujian Province, China

Published:2017-12-30 Online:2018-01-11
Contact: ZHANG Shengjian E-mail:zhangshengjian@yeah.net

摘要/Abstract

摘要： 背景与目的：腮腺基底细胞腺瘤(basal cell adenoma，BCA)发病率相对较低，临床误诊率高，目前为止，对该病的MRI表现报道较少。该研究结合动态增强磁共振成像(dynamic contrast enhanced magnetic resonance imaging，DCE-MRI)和扩散加权成像(diffusion weighed imaging，DWI)探讨BCA的MRI特征及其与病理学相关性。方法：回顾性分析经手术病理证实的26例腮腺BCA患者的临床表现、病理学改变及MRI影像学特征。分析患者临床表现、病灶数目、部位、大小、形态、信号与强化特征及其病理学表现。结果：26例患者中，女性18例；中位年龄51(32~72)岁；共27枚病灶(25例单发，1例双侧各1枚)。病灶平均大小22 mm(11~36 mm)。13枚病灶位于浅叶，5枚位于深叶，9枚同时累及深、浅叶；肿瘤呈圆形或椭圆形，均未见分叶，边界清楚，其中25枚病灶T2WI见周缘低信号环；对照颈部肌肉，病灶实性部分T1WI呈等或略高信号，T2WI呈高或略高信号，其中21枚病灶内见大小不一囊变区。增强后21枚病灶实性部分呈均匀强化，6枚呈不均匀强化。时间-信号强度曲线显示21枚病灶(77.8%)呈平台型，6枚(22.2%)呈流出型。9例患者(10枚病灶)行DWI检查，表观弥散系数图(apparent diffusion coefficient，ADC)均值为(1.22±0.20)×10^-3 mm²/s。镜下显示：肿瘤由单一基底细胞构成，并有明显的基底细胞层及基底膜样结构，缺乏黏液软骨样成分。结论：腮腺BCA的MRI表现有一定特征性，分析其MRI特征与其病理相关性，对于肿瘤的定性诊断及鉴别诊断有较大的价值。

关键词: 腮腺, 基底细胞腺瘤, 磁共振成像, 病理学

Abstract: Background and purpose: Basal cell adenoma (BCA) of the parotid gland has low incidence and high misdiagnosis rate in clinical practice. So far, the report on the MRI manifestation of BCA is rare. Our study combined dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) with diffusion weighed imaging (DWI) to investigate the MRI features of BCA of the parotid gland and its correlation with pathologic features. Methods: We retrospectively analyzed the correlation of MRI findings and pathology in 26 patients with histopathologically proven BCA of the parotid gland. The clinical presentation, pathologic features and localization, size, number, shape, signal, enhancement pattern of tumor were analyzed. Results: In this study, 18 patients (69.2%) were female and 8 patients (30.8%) were male. The median age was 51 (range 32-72) years. Twenty-five patients (96.2%) had single lesion and only one patient (3.8%) had two. The average size of the 27 lesions was 22 (range 11-36) mm. Thirteen lesions were located in superficial lobe, 5 in deep lobe and 9 across both lobes. All the 27 lesions had clear margin without lobular appearance and 25 lesions had complete or incomplete hypo-intensity rim in T2WI. Compared with neck muscle, all 27 lesions showed iso- or hyper-intense in T1WI and hyper-intense in T2WI. Twenty-one lesions (77.8%) had cystic change with varying size. The signal intensities of solid part of lesions were homogeneous in 21 lesions, heterogeneous in 6. Twenty-one lesions (77.8%) showed persistent enhancement and 6 (22.2%) had outflow enhancement. DWI was performed in 9 patients (10 lesions), the mean ADC value was (1.22±0.20)×10^-3 mm²/s. Under microscope, it consisted of a monomorphic population of basaloid epithelial cells, organized with prominent basal cell layer and distinct basement membrane-like material, lacking the myxochondroid stromal component. Conclusion: BCA of the parotid gland has certain clinical and MRI features. Analysis of the correlation between the MRI findings and the pathologic features may be helpful in making qualitative and differential diagnosis of BCA.

Key words: Parotid gland, Basal cell adenoma, Magnetic resonance imaging, Pathology

何慕真,盛箭,马明平,等. 腮腺基底细胞腺瘤MRI特征与病理对照分析[J]. 中国癌症杂志, 2017, 27(12): 935-939.

HE Muzhen, ZHANG Shengjian, MA Mingping, et al. MRI features of basal cell adenoma of the parotid gland and its correlation with pathology[J]. China Oncology, 2017, 27(12): 935-939.

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腮腺基底细胞腺瘤MRI特征与病理对照分析

MRI features of basal cell adenoma of the parotid gland and its correlation with pathology

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