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Objective: MSCT perfusion imaging in the parotid gland lesions characteristic of CT perfusion imaging, and pleomorphic adenoma adenolymphoma and parotid region malignant tumor perfusion parameters BV, BF, MTT and PS and tumor microvessel density (MVD) correlation. MATERIALS AND METHODS: collected since May 2008 to March 2010, due to the first diagnosis of parotid gland masses in 84 patients, a history of two days ranging from -16 years, including 82 cases of CT perfusion success, two cases due to technical reasons some level artifacts too large perfusion imaging failed excluded 82 cases confirmed by surgery and pathology or clinical follow-up results: 20 cases of mixed tumor 16 cases adenolymphoma, six cases of basal cell tumors, inflammation 16 cases of malignant tumors in 17 cases. There were 37 males and 41 females, aged 20-82 years, mean age 53.1 ± 16.6 years. CT perfusion examinations using GE lightspeed-16 MSCT in the parotid gland lesions before perfusion scan unenhanced determine parotid masses are interested in the area (ROI), intravenous injection of 50ml Ultravist 300 injection rate of 4ml / s scan after the completion of the original image data incoming GE.AW4.2 workstation, using CT Perfusion 3 package of soft tissue perfusion deconvolution algorithm for data processing, the maximum level in the parotid gland masses to manually draw interested District (ROI), in a substantial part of the lesion, select 1-3 ROI (ROI gt; 50 pixels), the selection principle: avoid visually discernible vascular shadow, necrosis, cystic areas and calcification, with the peripheral portion of the mass maintain a certain distance in order to reduce the partial volume effect. The computer automatically generate the TDC Figure perfusion parameters (BF, BV, MTT, PS) Figure, and calculate the the TDC characteristic parameters (time to peak, peak, peak enhancement values). Divided into five types (Ⅰ - Ⅴ type) of parotid masses TDC Figure based on its morphological characteristics, all data processing after the double-blind method by two radiologists, and record the TDC type, the three TDC characteristic parameter values ??as well as four perfusion parameters value of the mean. Choice of surgical specimens of 30 cases are three parotid tumors (10 cases of pleomorphic adenoma gland lymphoma, 10 cases, 10 cases of malignant tumors) were cut with CT perfusion target plane slice of the same organizational level, and then labeled with mouse anti-human CD34 MVD antibody immunohistochemical staining, first by two pathologists identify the three highest area of ??vascular density distribution, then replaced with 400 magnification, respectively, to select the three vascular density, and vascular density in the low magnification Perspective highest zone camera, using specialized analysis software, Image-Pro Plus 6.0 image acquisition and MVD, whichever is the mean value of MVD. Application SPSS17.0 software using analysis of variance lumps in the different pathological types parotid area mean compared pairwise comparisons of various perfusion parameters, Spearman rank correlation analysis three of parotid gland tumors BV, BF, MTT, PS, and MVD count between correlation. Results: 1. Parotid gland masses TDC type and the three TDC characteristic parameters value characteristics: parotid gland masses TDC type: mixed tumor and not the type I (slow rise obvious platform and decline) based; adenolymphoma Ⅱ type (fast rise and rapid decline no obvious platform) based; plateau basal cell tumor Ⅲ type (fast rise slightly slow down) the main; manifestation of inflammation TDC, the malignancy also similar, but Ⅳ (fast sawtooth-like fluctuations) was the main rise. Parotid gland tumor the TDC characteristic parameter value features: ① peak time of order: gland lymphoma, basal cell carcinoma, malignant lt; inflammation lt; mixed tumor; ② peak: mixed tumors, inflammation lt; gland lymphoma, malignant tumors lt; basal cell tumor; 3 peak enhancement values: mixed tumor lt; gland lymphoma, malignant lt; basal cell tumor; inflammation lt; basal cell tumor. Four perfusion parameters comparison parotid gland masses: lower mixed tumor of in MTT the longest, BV and BF; gland lymphoma and basal cell tumor BV and BF PS basal cell tumor is high compared to the other types of mass; perfusion characteristics of malignant tumors and inflammatory relatively insignificant, intersect larger. 4. The mixed tumor adenolymphoma of parotid gland malignancies perfusion parameters with their MVD correlation comparison: the three tumors BV are its MVD positively correlated; the three tumors MTT are negatively correlated with their MVD, but the difference was not significant ; pleomorphic adenomas and carcinomas BF and PS are its MVD positive correlation. Conclusion: 1.CT perfusion important value in the differential diagnosis of parotid gland masses, CT perfusion critical when treatment should be noted that the choice of functional blood vessels; the TDC type perfusion 2.CT, the TDC characteristic parameters and perfusion parameters BV, BF, MTT , PS values ??help identify the majority of parotid gland masses. Among them, the TDC type and the TDC characteristic parameters more valuable. (1) mixed tumor type Ⅰ the adenolymphoma type Ⅱ basal cell tumor type Ⅲ inflammation TDC more kind, malignant tumors also similar, but the main type Ⅳ. (2) the TDC characteristic parameters peak, peak enhancement values ??and peak time in the order of the parotid gland masses: ① peak time: adenolymphoma, basal cell carcinoma, malignant lt; inflammation lt; mixed tumor. ② peak: mixed tumor, inflammation lt; gland lymphoma, malignant lt; basal cell tumor. ③ peak enhancement value: mixed tumor lt; gland lymphoma, malignant lt; basal cell tumor; inflammation lt; basal cell tumor. (3) the characteristics of the parotid gland masses CT perfusion parameters: mixed tumor MTT longest, BV and BF; gland lymphoma and basal cell tumor BV and BF higher basal cell tumor PS adenolymphoma high; perfusion parameters characteristic of malignant tumors and inflammatory relatively obvious, there is a cross. 3. Mixed tumor, gland lymphoma and malignant tumor perfusion parameters and MVD correlation was positively correlated with BV, and MTT were negatively correlated, but the correlation is weak. 4.CT perfusion imaging in the evaluation of tumor microvascular function have an advantage over the immunohistochemical MVD count.
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