The Study Of The Clinical Manifestation And Radiology Of Salivary Gland Disease

PART1MULTI-SLICE SPIRAL COMPUTED TOMOGRAPHYFINDINGS OF SALIVARY GLAND PLEOMORPHICADENOMA AND DIAGNOSTIC VALUEObjective: To research the value of clinical features and Multi-sliceComputed Tomography(MSCT)of Salivary Gland PleomorphicAdenoma to improve its diagnostic accuracy.Methods: The clinical information and MSCT image features of47cases with Pleomorphic Adenoma proved by surgery and pathology duringJan.2011～Aug.2012were analyzed retrospectively.Results:In47cases,89.4%(42/47)were solitary lesion and10%(5/47)were multiple lesion in one side;59.6%(28/47)were located in parotidgland,17.0%(8/47)in submandibular gland,14.9%(7/47)in pars palatalisand8.5%(4/47)inbucca.During the surgery,27.7%(13/47)lesions adhereto the peripheral structure,10.6%(5/47) lesions have incompleteenvelope,19.1%(9/47)surfaces of lesions have nodules. On MSCT, mostGland Pleomorphic Adenoma are well-defined and iso-density masses.completely appear round. Among14.9%(7/47)cases with cysticdegeneration,6cases located to parotid gland especially in thepostoperatively recurrent and multiple cases. parotid gland andsubmandibular gland have no cystic degeneration.95.7%(45/47)casesshowed delayed reinforcemen(tdelayed180s).Because of the characteristicof anatomy of Hard Palate,4cases in it using three-dimensionalreconstruction technique by volume render (VR) and multiplanarreconstruction (MPR)not only enhance the detection ratio but alsomanifest the location, shape, size and the change of the adjacent sclerotinclearly.Conclusion: The MSCT manifestation of Gland PleomorphicAdenoma is a mass with iso-density, regular shape and clear margin.Especially the lesion located in Hard Palate is usually very small. usingthree-dimensional reconstruction technique routinely to manifest thelesion and the change of the adjacent sclerotin can improve preoperativediagnostic ratio. PART2THE CLINICAL MANIFESTATION AND IMAGINGFINDINGS OF THE TUBERCULOSIS OF THE PAROTIDGLANDObjective: To investigate the imaging findings with clinicalcharacteristics of the tuberculosis of the parotid gland.Methods: The CT and MRI data of12patients with tuberculosis of theparotid gland was analyzed retrospectively with emphasis on the shape,number, size, distribution, location and enhancement of the lesions anddistribution of enlarged cervical lymph nodes.Results: The12patients (mean age,68±10years, range,16to74)included5males and7females. The course of disease ranged from4day to14months.10patients (83.3%) had only painless mass in the region ofparotid gland, one patient (8.3%) had both pulmonary tuberculosis andspinal tuberculosis; one patient (8.3%) had suppuration in preauricularregion for one month. A total of23lesions were detected, which located inthe upper pole and lower pole of superficial lobe. Among the patients,7(58.3%) had single lesion and5(1.7%) had multiple ones. Among thelesions,8(34.8%) were round or oval,15were (65.2%) irregular, andranged in diameter from0.6to3.0cm. All patients had enlarged cervicallymph nodes, which mainly distributed in ipsolateral IIA (91.7%), IIB (75%)region and cervical superficial lateral region (66.7%).4lesions (17.4%)involved adjacent skin. There were4patterns of enhancement ondual-phase enhanced CT scan:1lesion (11.1%) with circular enhancement,4(44.4%) with chaplet-shaped enhancement,3(33.3%) with solid nodularenhancement and regional cystic region,1(11.1%) with solid nodular enhancement. The pattern of time-density curve of7lesions (77.8%) wascontinuing rising. On MRI images, the signal of lesions was slightly low onT1WI but high on the T2WI and DWI, and the lesions manifested ascircular enhancement. Soft tissue adjacent to lesions was alwaysedematous.Conclusion: Painless mass is the main clinical manifestation oftuberculosis of the parotid gland. Lesions usually located in the upper poleand lower pole of superficial lobe and manifested as circular,chaplet-shaped enhancement and solid nodular enhancement with orwithout regional cystic region. The main type of time-density curve iscontinuing rising. Lymph nodes in ipsolateral IIA, IIB region and cervicalsuperficial lateral region of neck usually enlarge.