【摘要】 目的 研究多层螺旋CT(MSCT)双期增强扫描结合彩色多普勒血流显像(CDFI)对腮腺良恶性肿瘤的诊断价值。方法分析手术病理证实的腮腺多形性腺瘤12例、腺淋巴瘤10例、缺乏恶性形态学CT表现特征的恶性肿瘤13例的术前MSCT双期增强扫描和CDFI影像资料,研究CT对腮腺肿瘤的诊断价值和限度以及CDFI诊断恶性肿瘤的阻力指数(RI)阈值,评价2种影像学手段相结合的诊断价值。结果(1)腺淋巴瘤与恶性肿瘤和良性多形性腺瘤的双期增强CT值均存在显著统计学差异(P<0.05),而后二者CT值差异无统计学意义(P>0.05);(2)MSCT双期增强扫描对腺淋巴瘤的定性诊断敏感度和特异度极高(分别为90%和100%),对良性多形性腺瘤和恶性肿瘤的定性诊断敏感度、特异度较低(分别为60.00%、65.21%和46.15%、59.10%);以RI≥0.77作为CDFI诊断恶性肿瘤的阈值标准,诊断敏感度和特异度分别为92.30%、83.33%;(3)采用MSCT双期增强扫描结合CDFI对恶性肿瘤的鉴别诊断敏感度、特异度分别为84.62%、100%。结论 MSCT双期增强扫描结合CDFI能弥补前者的不足,明显提高缺乏恶性形态学CT表现特征的腮腺恶性肿瘤的诊断准确度。更多还原

【Abstract】 Objective To investigate the diagnostic value of dual-phase enhanced multi-slice spiral CT(MSCT) combined with color Doppler flow imaging(CDFI) for the benign and malignant tumors of parotid gland.Methods The imaging data of dual-phase enhanced MSCT and CDFI in 12 cases with benign pleomorphic adenoma,10 cases with Warthin’s tumor and 13 cases with lack of morphological characteristic features of malignant tumors confirmed by pathology were analysed.The diagnostic value and limitation of dual-phase enhanced MSCT in the parotid tumors,and the threshold values of resistance index(RI) CDFI in diagnostic malignant tumors were evaluated.Results(1)The CT attenuation value at enhanced dual-phase in Warthin’s tumors was diffirentfrom that in malignant tumor and benign pleomorphic adenoma(P<0.05),but there were no statistical differences between malignant tumor and benign pleomorphic adenoma(P>0.05).(2)The sensitivity and the specificity were 90% and 100% respectively in diagnosis of Warthin’s tumor,60.00%,65.21% and 46.15%,59.10% respectively in pleomophic adenomas and malignant tumor.Taking into consideration of RI≥0.77 as the threshold for diagnosis of malignant tumor of the parotid gland,the sensitivity and the specificity in diagnosis of malignant tumor were 92.30% and 83.33%,respectively.(3)The sensitivity and the specificity in diagnosis of malignat tumor were 84.62% and 100% respectively by enhanced dual-phase MSCT in combination with the CDFI.Conclusion Contrast-enhanced dual-phase MSCT in combination with CDFI examination can improve the diagnostic accuracy of parotid malignant tumors which are subsequently lack of morphological characteristics.更多还原