眼眶淋巴瘤的磁共振成像特征  

Value of conventional MRI,DWI and DCE-MRI in the diagnosis of primary orbital lymphoma

作　　者：董洋[1] 曲晓峰[1] 刘伟[1] 陈宏海[1] 

机构地区：[1]大连医科大学附属第二医院放射科,116027

出　　处：《眼科》2016年第6期371-375,共5页Ophthalmology in China

摘　　要：目的分析眼眶淋巴瘤在MR常规序列、DWI及动态增强检查中的影像特征,探讨磁共振对眼眶淋巴瘤诊断的价值。设计回顾性病例系列。研究对象21例病理证实为原发性眼眶淋巴瘤患者的眼眶磁共振资料。方法所有患者均行T1WI、T2WI及T1WI压脂增强检查,8例(9眶)行动态增强、3例(4眶)行DWI检查。主要指标病灶位置及范围、形态、界限、与周围结构关系、信号特征、动态增强曲线特征。结果单侧发病17例、双侧发病4例,共25眶;16眶病变范围局限、9眶病变弥漫;病变位于眶隔前区6眶,泪腺区7眶,肌锥内6眶,肌锥区4眶,肌锥外12眶,视神经区2眶,骨膜下区1眶;病灶呈结节状10眶、铸型9眶、条片状2眶,7眶为眼外肌或视神经增粗或被包绕;病变界限清楚者13眶、界限不清者12眶;T1WI等信号23眶、稍低信号2眶,T2WI等信号19眶、稍高信号1眶、稍低信号5眶;4眶病灶DWI均呈等信号;增强扫描均匀明显强化者24眶,裂隙状不均匀明显强化者1眶;动态增强时间信号曲线呈平台型7眶,流入-流出型9眶,以上两种类型混合存在1眶。结论MR常规序列能够清晰显示眼眶淋巴瘤的位置、形态、内部特征及与周围器官的关系。DWI及动态增强可反映病灶的良恶性及恶性程度。Objective To analyze characteristics and diagnostic value of conventional Magnetic Resonance Imaging （MRI） combined with Diffusion Weighted Imaging （DWI） and dynamic contrast-enhanced MRI for the orbital lymphoma. Design Retrospective case series. Participants Twenty-one orbital lymphoma patients confirmed by pathology. Methods All patients underwent MR T1-weighted, T2-weighted and enhanced T1-weighted examinations, three patients underwent DWI and eight patients underwent dynamic contrast enhanced （DCE） MR imaging. Main Outcome Measures Focal location and extents, shape, boundary, relationship with the adjacent structures, the characteristics of MR signal （general sequence and DWI） and the time-intensity curve （TIC）. Results 17 patients had unilateral orbital lesions and 4 cases had bilateral orbital lesions. 16 orbits＇ lesions were local and 9 orbits were diffuse. The lesions involved anterior compartments in six orbits, lacrimal areas in seven, intraconal spaces in six, orbital muscles cones in four, extraconal spaces in twelve, optic nerve areas in two and subperiosteal area in one. Ten lesions＇ shapes were nodosity, nine lesions grew as ＂casting mould＂, two were pacity, and the exteaocular muscles or optic nerves were enlarged or wrapped in seven orbits. The lesions＇ margins of thirteen orbits were sharp and of twelve orbits were indistinct. The masses appeared iso-intensity in twenty-three orbits and slightly lower in two orbits on T1WI. The masses appeared iso-intensity in nineteen orbits, slightly higher signal in one orbit and slightly lower in five orbits on T2WI. The lesions in four orbits appeared iso-intensity on DWI. The lesions were enhanced markedly and homogeneously in twenty-four orbits but one. The TIC showed platform pattern in seven orbits, inflow-outflow pattern in nine and mixed pattern in one. Conclusion Conventional MRI can show the orbital lymphoma＇s location, shape, internal characteristics and the relationship with the surrounding structures. DWI and DC

关 键 词：眼眶淋巴瘤 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]