摘要
目的 分析原发性气管支气管涎腺肿瘤的影像学特点,以提高对该类疾病的认识与诊断水平。方法 选取36例原发性气管支气管涎腺肿瘤的CT检查与病理诊断资料,分析肿瘤的位置、大小、形态、密度、边缘、强化程度及气管腔外侵犯情况,有无纵隔肺门淋巴结增大及气道阻塞伴随征象。结果 36例患者中腺样囊性癌(ACC)21例、黏液表皮样癌(MEC)13例、上皮-肌上皮癌2例;ACC易发生于气管(18/21),MEC以支气管多见(11/13),2例上皮-肌上皮癌中气管、支气管各1例。MEC多呈膨胀性生长(12/13),表现为结节或肿块,边界多清晰;ACC多呈浸润性生长(14/21),表现为管壁弥漫或局限性增厚,差异有统计学意义(P<0.01);16例ACC(76.2%)肿瘤侵犯气管支气管壁向腔内外生长,MEC仅见1例(7.7%)腔外侵犯。增强扫描:ACC和MEC均以中度以上强化多见,分别为85.7%(18/21),61.5%(8/13)。结论 气管支气管涎腺肿瘤是一种罕见的肿瘤,影像学表现具有一定特点,原发性ACC和原发性MEC为两种主要的病理类型,其肿瘤影像学特征方面存在明显差异。CT检查对气管支气管内肿块检出和评估肿瘤范围具有重要价值,可以明确肿瘤的准确解剖、血流动力学信息,其最终诊断需要支气管镜活检病理证实。
Objective To retrospectively analyze the imaging features of primary tracheobronchial salivary gland tumors,so as to improve the understanding and diagnosis of these diseases.Methods CT and pathological data of 36 cases with primary tumors of tracheobronchial salivary gland were retrospectively analyzed.The location,size,shape,density,margin,degree of enhancement and intra tracheal lumen,mediastinal hilar lymph node enlargement,and airway obstruction were analyzed.Re-sults Among the 36 patients,21 cases were adenoid cystic carcinoma(ACC),13 cases were mucoepidermoid carcinoma(MEC)and 2 cases were epithelial-myoepithelial carcinoma.ACC was more likely to occur in trachea(18/21),and MEC was more common in bronchus(11/13).In 2 cases of epithelial-myoepithelial carcinoma,there was 1 case in trachea and 1 case in bronchus.Most MECs showed expansive growth(12/13),presented as nodules or masses with clear boundaries.ACC mostly showed invasive growth(14/21),which was manifested as diffuse or localized wall thickening(P<0.01).16 cases(76.2%)of ACC tumors invaded the bronchial wall and grew into and out of the lumen,while only 1 case(7.7%)of MEC tumors invaded the lumen.Enhanced scanning showed that ACC and MEC were slightly more moderately enhanced 85.7%(18/21)and 61.5%(8/13),respectively.Conclusion Tracheobronchial PSGT is a rare tumor with certain imaging characteristics,with two main pathological types,i.e.,PACC and PMEC.There are significant differences in tumor imaging characteristics.CT plain scan and enhancement are very useful in finding endobronchial masses and assessing the extent of the tumor.They can provide accurate anatomical and hemodynamic information of the tumor,whose final diagnosis,however,requires bronchoscopic biopsy and pathological confirmation.
作者
王振平
邢宁
WANG Zhenping;XING Ning(Department of Radiology,Hainan Traditional Chinese Medicine Hospital,Haikou 570203,China;Department of Radiology,General Hospital of Chinese PLA,Beijing 100853,China)
出处
《医学影像学杂志》
2025年第3期56-59,共4页
Journal of Medical Imaging
作者简介
王振平(1980-),男,医学硕士,主任医师,主要从事胸部、心血管及乳腺疾病的影像学诊断工作。
