眼眶淋巴瘤累及眼外肌的MRI分析  

Analysis of MRI features in lymphoma patients with extraocular muscle invasion

作　　者：郭鹏德[1,2] 燕飞[2] 张青[2] 李书玲[2] 常青林[2] 鲜军舫[2] 王振常[3] 

机构地区：[1]北京中医药大学附属东方医院放射科,北京100078 [2]首都医科大学附属北京同仁医院放射科,北京100730 [3]首都医科大学附属北京友谊医院放射科,北京100050

出　　处：《放射学实践》2015年第3期232-235,共4页Radiologic Practice

基　　金：北京市卫生系统高层次卫生技术人才(学科带头人2011-2-10);北京市自然科学基金(7112030);北京市优秀人才培养资助D类(2010D003034000033)

摘　　要：目的:通过MR图像探讨淋巴瘤累及眼外肌的数量、部位、程度及形态改变。方法:回顾性分析经病理证实的60例淋巴瘤并累及眼外肌的MRI图像。结果:60例患者共有75眼218条眼外肌受累,仅表现为眼外肌异常3例(4眼),伴有眶内其他结构受累57例(71眼)。眼外肌单侧受累45例,双侧受累15例。累及1条、2条、3条和4条及以上的眼外肌分别为20眼、14眼、20眼和21眼。累及提上睑肌48条,上直肌44条,下直肌27条,内直肌29条,外直肌32条,下斜肌25条,上斜肌13条。其中65条未见明显增粗,表现为受压变形或移位;153条增粗。增粗的眼外肌中,仅肌腱增粗7条,仅肌腹增粗10条,肌腱肌腹同时增粗58条,肌腹及后方肌腱增粗4条,整条眼外肌增粗74条。眼外肌形态呈条形45条,球形13条,不规则形160条。与同层面的脑灰质相比,增粗眼外肌主要呈等T1和等T2信号,增强扫描呈均匀轻度强化18条,均匀中等强化128条;不均匀轻度强化19条,不均匀中等强化53条。结论:淋巴瘤可以累及眼外肌,以多肌受累为主,形态多样,以等T1等T2信号为特征。Objective：To study the MRI characteristics of lymphoma with extraocular muscle invasion,including the number,location,degree of invasion and morphology changes.Methods：The MR images of 60 patients with pathology confirmed lymphoma with extraocular muscle invasion were retrospectively analyzed.Results：Of the 60 patients with lymphoma,totally 75 eyes with 218 pieces of extraocular muscle were invaded.Only extraocular muscles were invaded in 3patients（4eyes）,but invasion of extraocular muscle accompanied with other intra-ocular structures were showed in 57patients（71eyes）.Unilateral extraocular muscles were invaded in 45 patients and 15 patients had bilateral lesions.In total,20,14,20and21 eyes had invasion of one,two,three and ≥ four of extraocular muscles,respectively.The involved extraocular muscles were levator palpebrae superioris（n=48）,rectus oculi superior（n=44）,rectus oculi inferior（n=27）,rectus oculi medialis（n=29）,rectus oculi lateralis（n=32）,obliquus oculi inferior（n=25）,and 13 obliquus oculi superior（n=13）.Among the involved extraocular muscles,there were muscle compression or displacement yet with no enlargement（n=65）and muscle enlargement（n=153）.Of the oculi muscle with enlargement,the invaded pattern included only tendon（n=7）,only venter musculi（n=10）was effected,tendon accompanied with venter musculi（n=58）,venter musculi accompanied with posterior tendon（n=4）,and the entire muscle enlargement（n=74）.The morphology of invaded muscle showed as stripe shape（n=45）,spherical shape（n=13）and irregular shape（n=160）.Compared with the grey matter of the same level,the invaded muscle was isointense on T1 WI and T2 WI.After contrast administration,mildly and homogeneously（n=18）,moderately and homogeneously（n=128）,mildly and heterogeneously（n=19）,moderately and heterogeneously enhancement（n=53）were revealed.Conclusion：Lymphoma invasion of extraocular muscles was characterized by involvement of multiple muscles wit

关 键 词：眼眶 淋巴瘤 眼外肌 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.7[医药卫生—诊断学]