腮腺淋巴结结核的临床及影像学表现.docVIP

腮腺淋巴结结核的临床及影像学表现 张丹 吕发金 李鹏 彭聪 （重庆医科大学附属第一医院放射科，重庆 400016） 【摘要】 目的:探讨腮腺淋巴结结核的临床及CT、MRI表现,旨在提高对本病的认识及诊断准确率。材料和方法:回顾性分析2011.1-2012.9月经手术病理证实的12例腮腺淋巴结结核患者的临床及CT、MRI表现,观测病灶的形态、数目、大小、分布、强化方式及颈部肿大淋巴结的分布。结果:12 例患者中，男5例，女7例，平均年龄68 ± 10岁，病程4天至14个月不等，10例（83.3%）患者以腮腺区无痛性肿块就诊， 1例（8.3%）患者同时伴有双肺及脊柱结核,1例（8.3%）患者以耳前区流脓1月入院。12例共检出23个病灶, 均位于腮腺上极或下极浅叶，单发7例（58.3%），多发5例（41.7%），8个（34.8%）病灶呈类圆形，15个（65.2%）病灶呈不规则形，长径为0.6-3.0cm，12例患者均伴有颈部淋巴结肿大，以同侧IIA区（91.7%）、IIB区（75%）及颈外侧浅（66.7%）淋巴结肿大最常见。4个（17.4%）病灶累及邻近皮肤。 8例行CT双期增强扫描检出9个病灶，共4种强化方式：1个（11.1%）呈环形强化，4个（44.4%）呈花环状强化，3个（33.3%）呈局部囊变结节强化，1个（11.1%）呈实性结节强化，时间密度曲线（TDC）多呈上升持续型（77.8%），4例行MRI检查，其中2例行增强检查，共检出14个病灶,呈稍长T1等及稍长T2WI信号，DWI序列呈高信号，增强后呈环形强化，灶周软组织水肿。结论:腮腺淋巴结结核临床上多表现为腮腺区无痛性肿块，好发于腮腺上极或下极浅叶，增强后呈环形、花环状、局部囊变结节及实性结节，TDC多呈上升持续型，多伴有同侧颈部IIA、IIB区及颈外侧浅淋巴结肿大。 【关键词】 结核 腮腺淋巴结 体层摄影 X线计算机 磁共振成像 Tuberculosis of the parotid gland: the analysis of imaging findings with clinical features ZHANG Dan,Lv Fa-Jin,Li Peng,Peng Cong Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016,China [Abstract]Objective: To investigate the imaging findings with clinical characteristics of the tuberculosis of the parotid gland. Materials and Methods: The CT and MRI data of 12 patients with tuberculosis of the parotid gland was analyzed retrospectively with emphasis on the shape, number, size, distribution, location and enhancement of the lesions and distribution of enlarged cervical lymph nodes. Results: The 12 patients (mean age, 68 ± 10 years, range, 16 to 74) included 5 males and 7 females. The course of disease ranged from 4 day to 14 months. 10 patients (83.3%) had only painless mass in the region of parotid gland, one patient (8.3%) had both pulmonary tuberculosis and spinal tuberculosis; one patient (8.3%) had suppuration in preauricular region for one month. A total of 23 lesions were detected, which located in the upper pole and lower pole of superficial lobe. Among the patients, 7(58.3%) had single