首发于眼结膜的淋巴瘤MRI特征分析

目的 分析眼结膜淋巴瘤影像学表现，了解其MRI特征。设计 回顾性病例系列。研究对象 首诊于北京同仁医院眼科的21例眼结膜淋巴瘤患者。方法 分析21例患者临床表现、MRI影像学特征和病理诊断。主要指标 眼结膜淋巴瘤原发部位、范围及MRI特征。结果 21例（25眼）患者中，病变位于上睑结膜4眼，下睑结膜7眼，上下睑结膜同时受累14眼；病变局限于结膜或眼睑19眼，侵及眼眶6眼（2眼累及肌锥外间隙、眼外肌和泪腺，3眼累及眼上肌群，1眼累及Tenon囊及视神经）；边界欠清晰15眼，清晰10眼；17眼病变包绕眼球生长，8眼表现为眼球前部结节影。与眼外肌相比，所有病变T1WI均显示等信号，T2WI 18眼显示等信号，7眼显示稍高信号；18眼信号均匀，7眼不均匀或欠均匀。13例（15眼）进行增强扫描的病变均呈轻至中度强化，强化均匀8眼，不均匀7眼。7例（8眼）行动态增强扫描的病变，动态增强曲线表现为平台型6眼，流出型2眼。结论 眼结膜淋巴瘤MRI特征是呈等T1等或稍高T2信号，信号多均匀，增强呈轻中度强化，动态增强曲线呈平台型。（眼科，2013, 22：320-323）

Analysis of MRI features of lymphoma initiating in conjunctiva

Objective To deepen understanding the cognition of MRI features of conjunctival lymphoma. Design Retrospective cases series. Participants Twenty-one patients with conjunctival lymphoma first visiting the ophthalmology department of Beijing Tongren Hospital. Methods The clinical, MRI and histological features of 21 cases were reviewed. Main Outcome Measures The original locations, invasive extent， and MRI features of the tumor. Results In the 21 cases (25 eyes), the lesion located in the superior palpebrae conjunctiva in 4 eyes, the inferior palpebrae conjunctiva in 7 eyes, and both palpebrae conjunctiva in 14 eyes, respectively. Most of the lesions were limited to conjunctiva or eyelids (19 eyes, 76%) and others invaded the orbits (6 eyes, 24%; 2 eyes involving intraconal compartment, extraocular muscles and lacrimal gland; 3 eyes involving superior ocular muscles, 1 eye involving tenon follicle and optic nerve). There were well-defined margin in 15 eyes and ill-defined margin in 10 eyes. The lesions in 17 eyes circled the eye ball and in the other 8 eyes just located in the anterior eye segment. All the cases showed isointense on T1WI compared with ocular muscles. 18 eyes showed isointense and 7 eyes showed mild hyperintense on T2WI. Moreover, the signals were homogeneous in 18 eyes and heterogeneous in 7 eyes. 13 cases (15 eyes) had contrast-enhanced MRI. After injection of the Gd-DTPA, they showed mild to moderate enhancement. In 7 cases (8 eyes) for dynamic contrast-enhanced, 6 eyes showed plateau pattern and 2 eyes showed washout pattern in time-intensity curve. Conclusion Conjunctival lymphoma shows homogeneous isotense on T1WI and T2WI with mild to moderate enhancement in contrast-enhanced MRI， and plateau pattern in time-intensity curve. (Ophthalmol CHN, 2013, 22: 320-323)