中文摘要：

目的探讨不同组织学类型腮腺癌MSCT特征及其鉴别诊断。方法收集经病理证实的29例腮腺癌患者的CT影像资料，其中9例黏液表皮样癌，6例腺样囊性癌，5例淋巴上皮样癌，4例腺泡细胞癌，5例腺癌。对各类腮腺癌病灶的位置、大小、形态、密度、增强扫描特征、是否囊变或坏死及淋巴结转移情况进行回顾性分析，并探讨这些征象在鉴别诊断中的价值。结果①29例腮腺癌中粘液表皮样癌发病率最高，占31．03％，其次为腺样囊性癌，占20．69％；另外腺泡细胞癌病灶最大，其最大径平均约（2．82±1．89）cm。②各类型腮腺癌大部分病灶（60％以上）位于浅叶，病灶形态多以不规则为主，其中所有腺泡细胞癌表现为规则型（类圆形）。③腺样囊性癌和粘液表皮样癌发生囊变（坏死）比例最高，分别为83％和67％，而淋巴上皮样癌密度均匀一致，均未见囊变（坏死）征象。④淋巴结转移以淋巴上皮样癌发生率最高，占80％，而腺泡细胞癌无1例发生淋巴结转移。⑤腮腺癌中绝大部分呈“渐进性”强化模式，6例表现对“快进快退”强化模式，各类型腮腺癌表现中等及明显强化，其中腺泡细胞癌增强幅度及灌注率均最高；⑥性别、病灶位置、形态、大小、病灶囊变及坏死、淋巴结转移发生率、强化幅度和灌注率等在各类型腮腺癌之间的差异均无统计学意义（P〉0．05）。结论腮腺癌的MSCT表现具有一定的特征，但是该特征对不同组织学类型的分型价值有限。

英文摘要：

Objective To investigate the MSCT features in different histological types of parotid gland carcinoma and the value of each in differential diagnosis. Methods The CT images of 29 patients with confirmed parotid gland tumors were collected, including 9 cases of mucus epidermoid carcinoma, 6 cases of adenoid cystic carcinoma, 5 cases of lymphoid epithelioid carcinoma, 4 cases of glandular cell carcinoma and 5 cases of adenocarcinom. The location, lesion size, morphology, density, enhancement features, capsule and necrosis and lymphadenopathy on CT were retrospectively analyzed, and the value in differential diagnosis were discussed. Results ① Of 29 patients, mucus epidermoid carcinoma has the highest incidence, accounting for 31.03 %, followed by adenoid cystic carcinoma with 20.69 %. In addition, glandular cell carcinoma is the largest in volume, the mean diameter was （2.82 ± 1.89） cm. ② The majority （more than 60% ） in each types of parotid gland carcinoma were located in superficial lobe and the morphology were irregular, except that, all glandular cell carcinoma have a regular shape （oval）. ③ Mucus epidermoid carcinoma and adenoid cystic carcinoma had the highest incidence of capsule and necrosis, accounting for 83 % and 67 %, respectively. While the density of lymphoid epithelioid carcinoma was homogeneous, no case had capsule and necrosis. ④ Lymph node metastasis has the highest incidence in the lymphoid epithelioid carcinoma, accounting for 80 %, but were not observed in any case of glandular cell carcinoma. ⑤ The enhancement pattern of most parotid gland carcinoma presented gradual strengthening, and 6 cases showed fast forward fast rewind. Additionally, all types of parotid gland carcinoma presented moderate and significant reinforcement. ⑥ The gender, location, morphology, lesion size, capsule and necrosis, lymph node metastasis, enhancement range and perfusion ratio in different histological types of parotid gland carcinoma, did not causea significant difference （P 〉 0.05 ）