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논문 기본 정보

자료유형
학술저널
저자정보
전영섭 (인제대학교 의과대학 진단방사선과학 교실)
저널정보
대한영상의학회 대한방사선의학회지 대한방사선의학회지 제38권 제4호
발행연도
1998.1
수록면
609 - 616 (8page)

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Purpose : To determine the differential findings of benign and malignant parotid masses, as seen on CT and MR imaging. Materials and Methods : The CT(24 cases of benign and 10 cases of malignant masses) and MR imaging(18cases of benign and 9 cases of malignant masses) findings of parotid gland masses confirmed by surgery or histopathology were analyzed by two radiologists ; they focused on size, cystic change, the presence of calcification within the mass, density or signal intensity and margin, degree of contrast enhancement and homogeneity, location and bilaterality, associated findings-including infiltration into surrounding structures and lymphadenopathy. Results : In one of the 34 cases seen on CT, precontrast images were not available. In 15 of 23benign cases(65.2%), the density of the mass, as seen on pre-contrast enhanced CT scan, was lower than that of muscle. In ten malignant cases, density lower than that of muscle was noted in only two cases (20%). On T2-weighted images, low signal intensity to fat was noted in five of nine cases(55.5%) of malignant lesion, but in no cases involving benign parotid masses. On CT scanning, an indistinct margin of the masses was observed in five of 24 benign cases(20.8%) and three of ten malignant cases(30%), but on MR imaging, this was seen in three of 18benign cases(16.7%) and 6 of 9 malignant cases(66.7%). On pre-contrast enhanced CT scan, 15 of 23 benign cases showed homogenous density, but 12 of these 15 (80%) changed to inhomogenous on post-contrast enhanced CT scan. Among the 12, pleomorphic adenoma accounted for ten cases(83.3%). On CT scanning, infiltration into surrounding structures including subcutaneous fat tissue was observed in three of 24 benign cases(12.5%) and four of ten malignant cases(40.0%) ; and on MR imaging, in one of 18 benign cases(5.5%) and six of nine malignant cases(66.7%). Conclusion : If a mass of lower attenuation than that of muscle is seen on pre-contrast enhanced CT scan, or density patterns change from homogenous on pre-contrast CT to inhomogenous on post-contrast CT scan, the mass may be benign. However, for the differential diagnosis of benign and malignant parotid masses, the margin of the mass is not helpful. Masses which on T2-weighted MR images show an indistinct margin, lower signal intensity to fat and infiltration into surrounding structure are more likely to be malignant. CT and MR findings relating tomass size, cystic change within mass, and lymphadenopathy are not, however, helpful for the differential diagnosis of benign and malignant parotid masses.

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