泪腺炎症及淋巴细胞增生性病变的CT及磁共振成像诊断

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)

CT and MRI diagnosis of inflammation and lymphadenosis of lacrimal gland

Objective To investigate the CT and MRI findings of inflammation and lymphadenosis of lacrimal gland and to assess their diagnostic value.Design Retrospective case series study.Participants 46 patients with inflammation or lymphadenosis of lacrimal gland.Methods CT and MRI findings were analyzed retrospectively in 46 patients with inflammation or lymphadenosis of lacrimal gland,which were confirmed by pathology or clinical follow-ups.Main Outcome Measures Configuration,signal intense(or density)and extent of lesions.Results Of the 46 patients,32 patients with inflammatory pseudotumors demonstrated enlargement of the lacrimal gland,showing homogenous moderate density on CT,isointense or hypointense signal on T_1WI and T_2WI of MRI,and marked contrast enhancement.Multiple cystic components could be seen in one case.In 4 patients with Mikulicz disease,there were bilateral diffuse enlargment of the entire glands.CT scans showed homogenous moderate density.MRI showed hypointense signal on T_1WI and T_2WI,and marked contrast enhancement.Five patients with reactive lymphoid hyperplasia demonstrated enlargement of the lacrimal gland,homogenous moderate density on CT,hypointense or isointense signal on T_1WI and T_2WI(one case was hyperintense signal on T_2WI),and marked contrast enhancement.One patient with atypical lymphoid hyperplasia demonstrated bilateral diffuse enlargment of the entire glands,and homogenous moderate density on CT.4 patients had malignant lymphomas(B-cell lymphoma 3,histocytic sarco- ma 1,all 4 patients had bilateral disease),Those patients with malignant lymphomas showed bilateral diffuse enlargment of the entire glands.Conclusions The CT and MRI findings were similar in inflammation and lymphadenosis of lacrimal gland.CT and MRI may contribute to differentiate inflammation and lymphadenosis with epithelial tumors and may demonstrate the extent of the lesion.(Oph- thalmol CHN,2007,16:308-311)