眼眶肿瘤的彩色多普勒超声成像诊断分析

目的 探讨彩色多普勒超声成像(color Doppler imaging,CDI)在眼眶肿瘤的诊断和鉴别诊断中的价值.方法 对天津市眼科医院2007年1月至2008年12月117例(117侧眼眶)经术后病理证实的眼眶肿瘤患者的彩色多普勒超声检查结果进行回顾性对比分析.结果 117例眼眶肿瘤中,良性肿瘤96例:28例海绵状血管瘤,其中6例(21.4%)显示内部少量点状m流信号,2例可见动脉频谱;13例淋巴管瘤,其中6例(46.2%)肿瘤内部可见血流信号(4例为血管淋巴管瘤),5例显示动脉频谱;13例泪腺多形性腺瘤,其中9例(69.2%)肿瘤内部可见血流信号;14例神经鞘瘤,其中10例(71.4%)肿瘤内部可见血流信号;21例眼眶囊肿肿瘤内部则未见血流信号.恶性肿瘤21例:其中淋巴瘤12例,泪腺腺样囊性癌4例肿瘤内部均可见丰富血流信号,且为动脉频谱.余5例恶性肿瘤中4例内部均见丰富血流信号,仅1例低分化腺癌未见血流信号.在良性、恶性肿瘤中肿瘤内部显示血流信号比例分别占39.6%和95.2%.统计学分析表明良、恶性肿瘤内部血流收缩期峰值血流速度具有显著差异(P=0.000),阻力指数无明显差异(P＞0.05).结论 彩色多普勒成像对于某些眼眶肿瘤有特征性表现,在眼眶肿瘤的诊断,尤其是良、恶性肿瘤鉴别中有重要价值,同时对手术治疗有一定的指导意义.

The analysis of color Doppler imaging ultrasound in diagnosis of orbital tumors

Objective To approach the useful value of color Doppler imaging(CDI)ultrasound in the diagnosis and differential diagnosis of orbital tumor.Methods A total of 117 cases(117 eyes)of orbital tumors were analyzed retrospectively from 2007 to 2008 at Tianjin Eye Hospital.All the eases were diagnosed by postoperative pathologic diagnosis.Results Among 117 orbital tumors,there were 96 eases of benign tumors:From CDI ultrasound examination,there were 6 in 28 eases(21.4%)with cavernous haemangioma,6 in 13 eases(46.2%)with lymphangioma,9 in13 cases(69.2%)with benign mixed tumors of the lacrimal gland,10 in 13 cases(71.4%)showing blood flow.Twenty-one eases with orbital cyst showed no blood flow.There were 21 malignant tumors:12 eases with malignant lymphoma,4 eases with adenoid cystic carcinoma of lacrimal gland showed artery blood flow.The other 5 eases with malignant tumor showed abundant blood flow,except 1 case with poorly differentiated adenoeareinoma.There were 39.6% benign tumors and 95.2% malignant tumors showing blood flow.There were significant deviation in PSV between benign and malignant tumors(P=0.000)and no significant deviation in RI(P＞0.05).Conclusions There are special images in some orbital tumors from CDI ultrasound examination.Therefore,CDI is very useful in the diagnosis and differential diagnosis of orbital tumor,especially between benign and malignant tumors.It is important in guiding operations of orbital tumors.