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Platysma Infiltration on CT or MRI in Parotid Pathology

이하선 병변에서 활경근 침윤의 빈도와 조건

  • Hie Bum Suh (Department of Radiology, Pusan National University College of Medicine, Pusan National University Hospital) ;
  • Hak Jin Kim (Department of Radiology, Pusan National University College of Medicine, Pusan National University Hospital)
  • 서희붐 (부산대학교 의과대학 부산대학교병원 영상의학과) ;
  • 김학진 (부산대학교 의과대학 부산대학교병원 영상의학과)
  • Received : 2020.03.05
  • Accepted : 2020.06.23
  • Published : 2021.01.01

Abstract

Purpose To evaluate the incidence and condition of platysma infiltration in benign tumors, malignant tumors, and inflammatory disease in the parotid gland using CT or MRI. Materials and Methods Patients with benign tumors (n = 314), malignant tumors (n = 52), and inflammatory disease (n = 22) in the parotid gland were included. The incidence of platysma infiltration and the relationship between platysma infiltration and the location, capsular involvement, and focality of the mass were retrospectively evaluated using CT or MRI. Results The incidence of platysma infiltration was 0% in benign tumors,19.2% in malignant tumors (10/52), and 50.0% in inflammation (11/22). Platysma infiltration was positive in 10 of 13 patients with inflammatory lesion with capsular involvement. Platysmal infiltrations in inflammatory lesion showed diffuse lesion in 10 patients and focal lesion in one patient. Malignant tumor with platysmal infiltration showed all capsular involvement, and diffuse lesion in seven and focal lesion in three. Conclusion Platysma infiltration was more common in patients with inflammatory disease than those with malignant tumors or benign tumors. In inflammatory disease, platysma infiltration was more common in patients with capsular involvement or diffuse lesion.

목적 CT나 MRI에서 이하선의 양성종양, 악성종양 및 염증 질환에서 나타나는 활경근 침윤의 빈도와 어떤 상황에서 잘 일어나는지 그 조건을 알아보고자 하였다. 대상과 방법 이하선에서 발생한 양성종양 314명, 악성종양 52명 그리고 염증 22명을 대상으로 하였다. CT나 MRI에서 활경근 침윤의 빈도 및 병변의 위치, 피막침범 유무, 국소성에 따른 활경근 침윤 유무를 후향적으로 알아보았다. 결과 활경근 침윤의 빈도는 양성종양에서 0%, 악성종양에서 19.2% (10/52), 염증 환자에서 50% (11/22)였다. 피막을 침범한 염증 환자 13명 중 10명에서 활경근 침윤을 보였다. 활경근 침윤을 보인 염증 환자 11명 중 10명이 미만성을, 1명은 국소성을 보였다. 활경근 침윤을 보인 악성종양 총 10명 모두에서 피막을 침범하였으며, 그중 미만성 병변이 7명, 국소성이 3명이었다. 결론 이하선 질환에서 활경근 침윤은 악성종양보다 염증 질환에서 더 흔하게 일어났다. 염증 질환에서의 활경근 침윤은 이하선 피막을 침범하거나 미만성 병변일 경우 더 잘 나타났다.

Keywords

Acknowledgement

This work was supported by a 2-year Research Grant of Pusan National University.

References

  1. Gray H. Gray's anatomy. 20th ed. Philadelphia: Lea and Febiger 2008:387-440
  2. Lee JH. Anatomy of fascial spaces. In Kim HJ, Lee JH, eds. Head and neck radiology. 1st ed. Seoul: Panmuneducation 2015:610-629
  3. Ginsberg LE. Inflammatory and infectious lesions of the neck. Semin Ultrasound CT MR 1997;18:205-219
  4. Brook I. The bacteriology of salivary gland infections. Oral Maxillofac Surg Clin North Am 2009;21:269-274
  5. Zenk J, Iro H, Klintworth N, Lell M. Diagnostic imaging in sialadenitis. Oral Maxillofac Surg Clin North Am 2009;21:275-292
  6. Vogl TJ, Dresel SH, Spath M, Grevers G, Wilimzig C, Schedel HK, et al. Parotid gland: plain and gadoliniumenhanced MR imaging. Radiology 1990;177:667-674
  7. Freling NJ, Molenaar WM, Vermey A, Mooyaart EL, Panders AK, Annyas AA, et al. Malignant parotid tumors: clinical use of MR imaging and histologic correlation. Radiology 1992;185:691-696
  8. Kaiser HE. Characteristics and pattern of direct tumor spreading. In Brunson KW, ed. Local invasion and spread of cancer. 1st ed. Dordrecht: Springer 1989:1-16
  9. Osborn TM, Assael LA, Bell RB. Deep space neck infection: principles of surgical management. Oral Maxillofac Surg Clin North Am 2008;20:353-365
  10. Franklin BS, Bossaller L, De Nardo D, Ratter JM, Stutz A, Engels G, et al. The adaptor ASC has extracellular and 'prionoid' activities that propagate inflammation. Nat Immunol 2014;15:727-737
  11. Baroja-Mazo A, Martin-Sanchez F, Gomez AI, Martinez CM, Amores-Iniesta J, Compan V, et al. The NLRP3 inflammasome is released as a particulate danger signal that amplifies the inflammatory response. Nat Immunol 2014;15:738-748
  12. Mandelblatt SM, Braun IF, Davis PC, Fry SM, Jacobs LH, Hoffman JC Jr. Parotid masses: MR imaging. Radiology 1987;163:411-414
  13. Teresi LM, Lufkin RB, Wortham DG, Abemayor E, Hanafee WN. Parotid masses: MR imaging. Radiology 1987;163:405-409
  14. Som PM, Shugar JM, Sacher M, Stollman AL, Biller HF. Benign and malignant parotid pleomorphic adenomas: CT and MR studies. J Comput Assist Tomogr 1988;12:65-69
  15. Joe VQ, Westesson PL. Tumors of the parotid gland: MR imaging characteristics of various histologic types. AJR Am J Roentgenol 1994;163:433-438
  16. Tabor EK, Curtin HD. MR of the salivary glands. Radiol Clin North Am 1989;27:379-392
  17. Bag AK, Cure JK, Chapman PR, Pettibon KD, Gaddamanugu S. Practical imaging of the parotid gland. Curr Probl Diagn Radiol 2015;44:167-192
  18. Kessler AT, Bhatt AA. Review of the major and minor salivary glands, part 1: anatomy, infectious, and inflammatory processes. J Clin Imaging Sci 2018;8:47
  19. Smith MM, Mukherji SK, Thompson JE, Castillo M. CT in adult supraglottitis. AJNR Am J Neuroradiol 1996;17:1355-1358
  20. Becker M, Zbaren P, Hermans R, Becker CD, Marchal F, Kurt AM, et al. Necrotizing fasciitis of the head and neck: role of CT in diagnosis and management. Radiology 1997;202:471-476
  21. Bou-Assaly W, McKellop J, Mukherji S. Computed tomography imaging of acute neck inflammatory processes. World J Radiol 2010;28:91-96
  22. Glastonbury CM, Parker EE, Hoang JK. The postradiation neck: evaluating response to treatment and recognizing complications. AJR Am J Roentgenol 2010;195:W164-W171