眼眶腺样囊性癌的影像学研究

目的分析眼眶腺样囊性癌(ACC)的超声、CT及MRI等影像学特征。设计回顾性病例系列。研究对象经病理诊断证实的泪腺腺样囊性癌38例和副鼻窦来源的腺样囊性癌4例。方法分析眼眶腺样囊性癌超声、CT和MRI等各种影像学检查结果,记录图像特征。主要指标标准化A/B超、CT和MRI影像。结果ACC标准化A超表现为前部高波峰,后部低波峰和不规则高低混杂波峰两种类型。B超可显示肿瘤的轮廓,对于瘤内钙化及液化坏死等病变显示优良。CT扫描显示ACC有梭形、扁平形、团块状和不规则形等四种形状,对于肿瘤的边界、空间位置,骨破坏和骨吸收等继发改变显示清晰。ACC在T_1加权像为中信号,T_2加权像有均一的等信号,等、低信号混杂和等、高信号混杂三种,多数不均匀强化。强化MRI有利于显示肿瘤的蔓延途径,泪腺ACC有多种蔓延途径。副鼻窦ACC易累及筛窦和上颌窦。结论各种影像学检查可显示眼眶ACC的不同特性。综合运用和分析各种影像学检查结果可提高诊断水平。(眼科,2007,16:391-394)

Imaging of orbital adenoid cystic carcinomas

Objective To describe the imaging features of ultrasound,computer tomography(CT)and magnetic resonance imaging (MRI)for orbital adenoid cystic carcinoma(ACC).Design Retrospective case series.Participants Thirty-eight cases of adenoid cystic carcinoma arising from larcrimal glands and 4 cases from accessory nasal cavities confirmed by histologic method.Methods The fea- tures of ultrasound,CT and MRI images of ACC patients were analyzed.Main Outcome Measures Images of standardized A-mode e- chography,B-ultrasound,CT and MRI.Results ACC had two types on standardized A-mode echography images:anterior high spikes with posterior low spikes;irregular high or low spikes.B-ultrasound could clearly display calcification,liquid cavities in the lesions.In our series,tumors were showed four shapes on CT images,which were fusiform,flat,block-shape and irregular shape.CT could sharply display the margin,the location of tumors and secondary osteoclasia as well as resorption.On T_(?)-weighted images ACC was showed isointensity,which displayed three types of intensity on T_2-weighted images,which were homogenous isointensity,iso-/hypointensity and iso-/hyperintensity.Majority of ACC were heterogeneously enhanced.The enhanced MRI contributed to displaying the extension paths of tumors.The extension paths of lacrimal gland ACC were varied.Accessory nasal cavities with ACC always involved ethmoidal and sphe- noidal sinus.Conclusion Ultrasound,CT and MRI can show differental features of orbital ACC.The level of diagnosis can be improved with the combined application of imaging methods.(Ophthalmol CHN,2007,16:391-394)