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目的研究泪腺炎症及淋巴细胞增生性病变的CT和MRI表现及其诊断价值。设计回顾性病例系列。研究对象泪腺炎症及淋巴细胞增生性病变患者46例。方法回顾分析46例经病理学或临床证实的泪腺炎症及淋巴细胞增生性病变患者的CT及MRI影像资料。主要指标病变形态、信号(密度)、累及范围。结果46例患者中炎性假瘤32例,表现为泪腺体积增大,CT示泪腺呈均匀等密度,MRI T_1WI及T_2WI呈等或低信号,1例可见多发囊变,MRI增强扫描病变强化明显。Mikulicz病4例,均为双侧泪腺弥漫增大,CT呈均匀等密度,MRI T_1WI及T_2WI均呈低信号,增强后呈明显均匀强化。反应性淋巴细胞增生5例,表现为泪腺体积增大,CT呈均匀等密度,MRI T_1WI、T_2WI呈低或等信号,1例T_2WI呈高信号,增强扫描呈明显强化。非典型性淋巴细胞增生1例,CT表现为双侧泪腺弥漫性增大,密度均匀。泪腺淋巴瘤4例(B细胞淋巴瘤3例,组织细胞肉瘤1例),表现为双侧泪腺弥漫性增大。结论泪腺炎症及淋巴细胞增生性病变的影像表现相似,CT及MRI有助于病灶与泪腺上皮性肿瘤的鉴别,并可准确显示病变累及范围。(眼科,2007,16:308-311)
Objective To study CT and MRI findings of lacrimal gland inflammation and lymphoproliferative lesions and its diagnostic value. Design retrospective case series. Study of 46 patients with lacrimal gland inflammation and lymphoproliferative disorders. Methods Retrospective analysis of 46 cases of pathological or clinically confirmed lacrimal gland inflammation and lymphoproliferative lesions in patients with CT and MRI image data. The main indicators of lesion morphology, signal (density), involving the range. Results The inflammatory pseudotumor was found in 32 of 46 patients. The volume of lacrimal gland was increased. The lacrimal gland was uniformly isodense in CT. The MRI T1WI and T2WI showed equal or low signal. One case showed multiple cystic degeneration. . Four cases of Mikulicz disease were diffusely enlarged on both sides of the lacrimal gland. CT showed a uniform and uniform density. MRI T_1WI and T_2WI showed low signal intensity and markedly uniform enhancement after enhancement. Reactive lymphocyte hyperplasia in 5 cases, showing increased volume of lacrimal gland, CT was uniform density, MRI T_1WI, T_2WI was low or equal signal, T_2WI was a high signal, enhanced scan was significantly enhanced. 1 cases of atypical lymphocytic hyperplasia, CT showed diffuse diffuse increase of both lacrimal glands, uniform density. 4 cases of lacrimal gland lymphoma (B-cell lymphoma in 3 cases, 1 case of tissue cell sarcoma), manifested as diffuse bilateral lacrimal gland enlargement. Conclusions The manifestations of lacrimal gland inflammation and lymphoproliferative lesions are similar. CT and MRI are helpful to differentiate the lesion from lacrimal gland epithelial tumor and can accurately show the extent of lesion involvement. (Ophthalmology, 2007,16: 308-311)