头颈部木村病的临床特点和MRI表现(1)
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【摘要】 目的 探讨头颈部木村病的MRI影像学表现及临床特点,提高对该疾病的认识和诊断水平。方法 搜集经手术病理证实的头颈部木村病12例完整资料,所有病例术前均行MR平扫与增强扫描,回顾性分析其临床及MRI表现。结果 本病青中年男性多见,12例木村病病程长(平均6年),表现为颌下、腮腺及耳后区的慢性无痛性肿块,12例外周血检查中嗜酸性粒细胞明显增高,占白细胞总数的28%~65%。MRI表现为:①单侧腮腺、颌下腺浅叶弥漫性增大,常伴有多个结节,或者单侧耳廓弥漫肿大,腮腺仅轻度增大;②同侧腮腺周围、颌下区淋巴结受累,淋巴结信号均匀,强化均匀,边缘光整,未见融合;部分病例双侧上颈深部淋巴结受累。结论 木村病具有一定的影像特点,结合临床表现和实验室指标,术前可以诊断。
【关键词】
头颈部;木村病;磁共振成像
The clinical characters and MRI findings of kimura disease of head and neck
YUAN Xiao-ping, HUANG li，HUANG Sui-qiao,et al.Department of Radiology of Sun Yet-Sen Memorial Hospital， Sun Yet-Sen University，Guangzhou 510120，China
【Abstract】 Objective To investigate the MRI findings and clinical characters of kimura disease, To improve the understanding of the disease diagnosis. Methods Kimura disease in 12 cases was verified with histopatholgy. Pre-and post-contrast MR were performed preoperatively in all patients，the clinical data and MRI findings were reviewed retrospectively.Results The disease often occured in young adult groups, more than men，12 cases with Kimura disease had long clinical courses (averaged 6 years). The chief complain were submandibular or parotid gland indolent mass without any pain. Laboratory examination of blood showed that all cases had higher eosinophilic with 28% ~65% of the white cells. MRI findings：(1)the unilateral parotid or submandibular gland, often accompanied by multiple nodules, or diffuse enlargement, unilateral auricle parotid only mild enlargement；(2)bilateral parotid or submandibular lymph nodes involvement, uniform, aggrandizement, signal the edge, fusion, Part of bilateral cases cervical lymph node involvement in the deep. The density of the masses and lymphnodus was homogeneous without necrosis and cyst. Conclusion The imaging findings of Kimura disease have some characteristic features， the diagnosis can be made combined with the laboratory examination and clinical findings before operation.
【Key words】 Head and Neck；Kimura disease；Magnetic resonance imaging
木村病是一种良性的淋巴组织增生性疾病,由我国金显宅等[1]在1937年首先报道,当时以嗜伊红细胞性增生性淋巴肉芽肿(eosinophilichyper-plasticlymphogranuloma)命名。1948年日本的木村哲二(Kimura)[2]等以“伴有淋巴组织增生的特殊肉芽肿(unusualgranulationcombinedwithhyperplas-ticchangesoflymphatictissue)”对本病进行了系统的描述,之后多数学者遂称此病为(Kimura’sDisease;KD)病 ......
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