13例涎腺导管癌的影像学表现分析

doi:10.6040/j.issn.1671-7554.0.2020.1070

摘要/Abstract

摘要： 目的探讨涎腺导管癌(SDC)的影像学表现,以提高对该病的认识。方法回顾性分析经手术病理证实的 13例SDC患者的CT及MR资料,观察病变的影像学特征。结果 13例患者中男性12例,女性1例,中位年龄64岁;12例行CT平扫及增强扫描,1例行MR平扫;病变均表现为单发肿块,其中位于腮腺9例,颌下腺2例,舌下腺1例,小涎腺1例;肿瘤大小不一,长径平均约3.3 cm;13例病灶边界均不清晰,呈浸润性生长,对周围组织不同程度侵犯,其中5例就诊时已有远处转移;平扫病变密度/信号不均匀11例,较均匀2例;CT增强扫描明显强化8例,中度强化3例,轻度强化1例;10例CT病灶中心见凝固性坏死区,坏死不彻底时可见轻度强化,1例MR病灶中心内见凝固性坏死,周围包绕低信号纤维环;伴颈部淋巴结转移者9例。结论 SDC的影像学表现具有一定特征性,肿瘤内出现凝固性坏死区有利于该病的诊断与鉴别。

关键词: 涎腺肿瘤, 涎腺导管癌, X线体层摄影术, 磁共振成像

Abstract: Objective To explore the imaging manifestations of salivary duct carcinoma(SDC). Methods The CT and MRI data of 13 confirmed cases of SDC were retrospectively analyzed. Results There were 12 male and 1 female, with a median age of 64 years. CT plain scan and enhanced scan were performed in 12 patients, and MR plain scan was performed in 1 patient. All lesions were single mass, located in the parotid glands(9 cases), submandibular glands(2 cases), sublingual glands(1 case), and minor salivary gland(1 case). Tumors varied in size, with an average long diameter of 3.3 cm. Thirteen tumors had unclear boundary, invading the surrounding tissues to varying degrees, among which 5 had distant metastasis at the time of admission. Inhomogeneous density/signal of lesions in plain scan was found in 11 cases and homogeneous in 2 cases. CT scan showed significant enhancement in 8 cases, moderate enhancement in 3 cases and mild enhancement in 1 case. Coagulative necrosis was observed in 10 CT images, and slight enhancement was seen when the necrosis was incomplete. Coagulative necrosis was observed in 1 MR image, which was surrounded by a low signal fiber ring. Cervical lymph node metastasis was observed in 9 cases. Conclusion The imaging manifestations of SDC has certain characteristics, and the presence of coagulative necrosis can help the diagnosis and differentiation of this disease.

Key words: Salivary gland neoplasm, Salivary duct carcinoma, X-ray tomography, Magnetic resonance imaging

中图分类号:

R455.5

陈晓丽,桂振朝,高杨,邢梦瑶,修建军. 13例涎腺导管癌的影像学表现分析[J]. 山东大学学报 (医学版), 2021, 59(1): 78-82.

CHEN Xiaoli, GUI Zhenchao, GAO Yang, XING Mengyao, XIU Jianjun. Imaging findings of 13 cases of salivary duct carcinoma[J]. Journal of Shandong University (Health Sciences), 2021, 59(1): 78-82.

参考文献

[1] Kleinsasser O, Klein HJ, Hübner G, et al. Salivary duct carcinoma. a group of salivary gland tumors analogous to mammary duct carcinoma [J]. Arch Klin Exp Ohren Nasen Kehlkopfheilkd, 1968, 192(1): 100-105.
[2] 林楠, 蔡菁华, 许曼君, 等. 40例唾液腺导管癌的临床病理分析[J]. 中华口腔医学杂志, 2019, 54( 6): 416-419. LIN Nan, CAI Jinghua, XU Manjun, et al. Clinicopathological analysis of 40 cases of salivary duct carcinoma [J]. Chinese Journal of Stomatology, 2019, 54(6): 416-419.
[3] Otsuka K, Imanishi Y, Tada Y, et al. Clinical outcomes and prognostic factors for salivary duct carcinoma: a multi-institutional analysis of 141 patients [J]. Ann Surg Oncol, 2016, 23(6): 2038-2045.
[4] Jayaprakash V, Merzianu M, Warren GW, et al. Survival rates and prognostic factors for infiltrating salivary duct carcinoma: analysis of 228 cases from the surveillance, epidemiology, and end results database [J]. Head Neck, 2014, 36(5): 694-701.
[5] 何时, 何同梅, 卢建平, 等. 31例涎腺导管癌的临床病理分析[J]. 临床与病理杂志, 2019, 37(3): 1412-1419. HE Shi, HE Tongmei, LU Jianping, et al. Clinicopathologic features of 31 cases of salivary duct carcinoma [J]. Journal of Clinical and Pathological Research, 2019, 37(3): 1412-1419.
[6] 马红梅, 吉新华, 黎柯露, 等. 涎腺导管癌 4 例临床病理分析[J]. 临床与实验病理学杂志, 2019, 35(6): 699-701. MA Hongmei, JI Xinhua, LI Kelu, et al. Clinicopathologic analysis of 4 cases of salivary duct carcinoma [J]. Chinese Journal of Clinical and Experimental Pathology, 2019, 35(6): 699-701.
[7] Guzzo M, Di Palma S, Grandi C, et al. Salivary duct carcinoma: clinical characteristics and treatment strategies [J]. Head Neck, 1997, 19(2): 126-133.
[8] 卫英, 江明祥, 邵国良, 等. 涎腺导管癌的 CT、MR 表现与病理对照分析[J]. 影像诊断与介入放射学, 2015, 24(4): 267-271. WEI Ying, JIANG Mingxiang, Shao Guoliang, et al. CT, MRI findings and pathological analysis of salivary duct carcinoma [J]. Diagnostic Imaging & Interventional Radiology, 2015, 24(4): 267-271.
[9] Xie S, Yang H, Bredell M, et al. Salivary duct carcinoma of the parotid gland: a case report and review of the literature [J]. Oncol Lett, 2015, 9(1): 371-374.
[10] Hosal AS, Fan C, Barnes L, et al. Salivary duct carcinoma [J]. Otolaryngol Head Neck Surg, 2003, 129(6): 720-725.
[11] 王洁, 钟鸣, 王兆元, 等. 涎腺导管癌4例临床病理分析并文献复习[J]. 中国实用口腔科杂志, 2008, 12(12): 736-737. WANG Jie, ZHONG Ming, WANG Zhaoyuan, et al. The pathological analysis of salivary duct carcinoma and literature review [J]. Chinese Journal of Practical Stomatology, 2008, 12(12): 736-737.
[12] Jaehne M, Roser K, Jaekel T, et al. Clinical and immunohistologic typing of salivary duct carcinoma [J]. Cancer, 2005, 103(12): 2526-533.
[13] Kadowaki S, Yatabe Y, Hirakawa H, et al. Complete response to trastuzumab-based chemotherapy in a patient with human epidermal growth factor receptor-2-positive metastatic salivary duct carcinoma expleomorphic adenoma [J]. Case Rep Oncol, 2013, 6(3): 450-455.
[14] 陈夏季, 黄丹, 林敏娜. 腮腺腺淋巴瘤磁共振成像的影像学表现[J]. 实用医学影像杂志, 2020, 21(2): 138-140. CHEN Xiaji, HUANG Dan, LIN Minna. Imaging findings of magnetic resonance imaging of parotid gland lymphoma [J]. Journal of Practical Medical, 2020, 21(2): 138-140.
[15] 张慧红, 乐洪波, 吴先衡, 等. 涎腺黏液表皮样癌 CT的诊断[J]. 临床放射学杂志, 2015, 34(12): 1890-1894. ZHANG Huihong, LE Hongbo, WU Xianheng, et al. CT Diagnosis of Mucoepidermoid Carcinoma in Salivary Glands [J]. Journal of Clinical Radiology, 2015, 34(12): 1890-1894.
[16] 伍丹丹,郭军,孟庆江,等. 头颈部腺样囊性癌的CT诊断[J]. 实用口腔医学杂志, 2019, 35(6): 887-890. WU Dandan, GUO Jun, MENG Qingjiang, et al. CT diagnosis of adenoid cystic carcinoma of the head and neck [J]. Journal of Practical Stomatology, 2019, 35(6): 887-890.
[17] 刘灶松, 叶瑶, 魏新华, 等. 涎腺腺样囊性癌的CT、MRI表现及病理对照研究[J]. 中国CT和MRI杂志, 2017, 15(11): 41-44. LIU Zaosong, YE Yao, WEI Xinhua, et al. The CT and MRI Findings and Pathological Basis of Adenoid Cystic Carcinoma of the Salivary Glands [J]. Chinese Journal of CT and MRI, 2017, 15(11): 41-44.
[18] 王臣, 齐志刚, 杜祥颖, 等. 鼻窦鼻腔及颅底腺样囊性癌的CT和MRI特点分析[J]. 医学影像学杂志, 2019, 29(11): 1823-1826. WANG Chen, QI Zhigang, DU Xiangying, et al. CT and MRI findings of adenoid cystic carcinoma in nasal cavity, paranasal sinus and skull base [J]. Journal of Medical Imaging, 2019, 29(11): 1823-1826.

相关文章 15

[1]	金晨曦,沈薇,李娜,孙建锋,杨驰,郭泾. ADDWoR关节镜下盘复位术盘-髁运动的定量分析[J]. 山东大学学报 (医学版), 2025, 63(7): 54-61.
[2]	刘晶晶,庞婧,赵晓丹,林昕,付敏,陈静静. 基于乳腺X线摄影及DCE-MRI机器学习模型预测乳腺癌新辅助治疗后病理完全缓解:双中心研究[J]. 山东大学学报 (医学版), 2025, 63(1): 60-72.
[3]	刘小文,曹永泉,侯明源,于德新. EOB-MRI多定量参数对肝胆期乏血供低信号结节进展风险的评估价值[J]. 山东大学学报 (医学版), 2024, 62(4): 31-39.
[4]	吴思雨,沈业隆,王锡明. 影像组学预测原发性中枢神经系统淋巴瘤的Ki-67标记指数[J]. 山东大学学报 (医学版), 2024, 62(11): 67-72.
[5]	靳新娟,左立平,邓展昊,李安宁,于德新. MRI影像组学对135例肝癌耐药蛋白PFKFB3的预测价值[J]. 山东大学学报 (医学版), 2023, 61(6): 79-86.
[6]	王磊,张帅,刘钢,由胜男,王植,朱珊,陈超,马信龙,杨强. MRI诊断140例腰椎智能网络自动检测分型MCs方法的比较[J]. 山东大学学报 (医学版), 2023, 61(3): 71-79.
[7]	杨咏青,赵鹏,汪玉,马文静,田迷迷,程亚旎,祖璐,林祥涛. 细胞外容积分数对62例不同病理类型肺癌的诊断价值[J]. 山东大学学报 (医学版), 2023, 61(2): 88-94.
[8]	靳新娟,蔡大幸,范金蕾,邓展昊,李楠,于德新,李安宁. 显微镜高分辨率MRI鉴别皮肤良、恶性局灶隆起性结节[J]. 山东大学学报 (医学版), 2023, 61(12): 51-61.
[9]	赵恩举,赵硕,郭云亮,王锡明. 282例颈动脉钙化与脑小血管病MRI总负荷评分的关联性[J]. 山东大学学报 (医学版), 2023, 61(1): 38-44.
[10]	陶国伟,王芳,董向毅,徐亚瑄,赵琳丽,胡蓓蓓. 子宫腺肌病的超声与MRI诊断及进展[J]. 山东大学学报 (医学版), 2022, 60(7): 56-65.
[11]	冯宝民,王舟,徐晗,李佳存,于乔文,修建军. 抗髓鞘少突胶质细胞糖蛋白IgG抗体相关疾病临床及影像特征[J]. 山东大学学报 (医学版), 2022, 60(3): 45-50.
[12]	左立平,蒋丰洋,周斌彬,范金蕾,梁永锋,邓展昊,于德新. 术前MRI在预测169例肝细胞肝癌微血管侵犯及早期复发的价值[J]. 山东大学学报 (医学版), 2022, 60(3): 89-95.
[13]	刘学业,李齐明,唐弘毅,徐秋平,陈文倩,郭泾. 年轻成人颞下颌关节髁突体积、表面积与关节盘矢向位置的关系[J]. 山东大学学报 (医学版), 2021, 59(6): 117-121.
[14]	张高瑞,张玉婷,赵雨萱,王方青,于德新. MnFe₂O₄@CNS纳米探针在胰腺癌诊疗一体化中的价值[J]. 山东大学学报 (医学版), 2021, 59(4): 48-55.
[15]	宋珍珍,孙小玲,李海鸥,王芳,张冉,于德新. 120例胶质瘤及瘤周水肿MRI影像组学在评估肿瘤复发中的价值[J]. 山东大学学报 (医学版), 2021, 59(11): 53-60.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed