摘要
目的 探讨气管支气管树涎腺样肿瘤的影像表现 ,以提高诊断正确率。方法 回顾性分析经组织学证实的腺样囊性癌 (ACC) 6 2例 ,其中有术前影像资料者 40例 ,包括传统X线检查 33例 ,CT扫描 2 1例 (增强扫描 11例 )。黏液表皮样癌 (MEC) 2 7例 ,有术前影像资料者 18例 ,包括传统X线检查 17例 ,CT扫描 6例 (增强扫描 5例 )。结果 (1)病变部位 :ACC :中央型 37例 ,以原发气管最多(2 6例 ) ,周围型 3例 ;MEC :中央型 13例 ,以叶支气管起源为主 (8例 ) ,周围型 5例。除 1例ACC外 ,周围型病变均位于肺中野内带、邻近肺门。 (2 )CT表现 :ACC :18例中央型病变中腔内型 3例、腔内外型14例 (伴管壁浸润状增厚 8例 )、单纯管壁浸润状增厚型 1例 ;平扫密度均低于或近、等于肌肉 ,11例增强后密度仍低于或近、等于肌肉者 8例 ;病变边缘呈浸润状 ,提示外侵 8例。MEC :6例中央型病变中腔内型 5例、腔内外型 1例 ,无一例有管壁浸润状增厚 ;增强后病变明显强化高于肌肉 4例 ;瘤内点状钙化 3例 ;病变远端见低密度黏液栓 1例 ;病变边缘清楚 ,未见明确局部侵犯。结论 气管支气管树涎腺样肿瘤好发于大气道 ,ACC多见于气管 ,MEC多见于气管分叉下大气道。两者均可表现为腔内型、腔内外型及近肺门的周围型肿物。ACC以腔内外型为?
Objective To assess the imaging features of the salivary gland-like neoplasms (SGN) of the tracheobronchial tree, including adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma (MEC). Methods Eighty-nine cases of SGN of the tracheobronchial tree were reviewed. There were 62 cases of ACC (male 33, female 29; age range, 20-73 years) and 27 cases of MEC (male 16, female 11; age range, 16- 60 years). 40 cases of ACC and 18 cases of MEC had imaging materials before surgical treatment. For ACC, 33 cases had conventional radiograph and 21 cases had CT scan. For MEC, 17 cases had conventional radiograph and 6 cases had CT scan. Results (1) Location: 37 cases of ACC were central type and most of them (26 cases) located at trachea, 3 cases were peripheral type. 13 cases of MEC were central type and mainly located at lobar bronchi (8 cases). 5 cases were peripheral type. Of the peripheral lesions, all except one ACC were located at the inner field of the lung adjacent to the hilus. (2) CT findings: Of the 18 cases of central type of ACC, there were intraluminal (3 cases), intra-and-extraluminal extension (14 cases, 8 cases with wall thickening), and infiltrative wall thickening (1 case) lesions. The attenuation of the tumor was lower or similar to that of the muscle in all of the plain scans and in 72.2% cases after contrast-enhancement. Infiltration of the adjacent tissue or organs was detected in 8 cases. Of the 6 cases of central type of MEC, there were intraluminal (5 cases) and intra-and- extraluminal extension (1 case) lesions. Marked enhancement of the mass (4 cases) and calcification (3 cases) were seen. The margin of MEC was well-defined, and no local infiltration was found. Conclusion SGN of the tracheobronchial tree tended to be originated at major airways. ACC mostly located at trachea, whereas MEC located at lobar bronchi. Both had the manifestations of intraluminal, intra-and-extraluminal, and peripheral lesions adjacent to the hilus. ACC tended to have extraluminal extension and infiltrative wall thickening due to their invasive character. Low attenuation was shown in plain scan and with minimal enhancement after contrast administration. MEC mostly manifested as intraluminal type without infiltrative wall thickening, but with distinct enhancement. About half of the tumors had intratumoral calcification and mucous impaction could be identified.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2002年第2期127-130,共4页
Chinese Journal of Radiology
关键词
气管肿瘤
腺样囊性癌
涎腺样肿瘤
CT
诊断
X线诊断
Tracheal neoplasm
Carcinoma,adenoid cystic
Carcinoma, mucoepidermoid
Tomography, X-ray computed
