眼眶淋巴瘤多模态影像分析  

Multimodal imaging analysis of orbital lymphoma

作　　者：叶慧芬 王广谊[2] 刘恩涛 朱超 陈明蕾 刘再毅[2,3] 梁长虹 YE Hui-fen;WANG Guang-yi;LIU En-tao(The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学第二临床医学院,广州510515 [2]广东省人民医院,广东省医学科学院放射科,广州510080 [3]广东省医学影像智能分析与应用重点实验室,广州510080 [4]广东省人民医院,广东省医学科学院核医学科,广州510080

出　　处：《放射学实践》2022年第11期1353-1358,共6页Radiologic Practice

基　　金：国家重点研发计划(2021YFF1201003);广东省重点领域研发计划项目(2021B0101420006);国家自然科学基金杰出青年科学基金(81925023);国家自然科学基金(82071892);高水平医院建设科研专项(DFJHBF202105);高水平医院建设科研专项(DFJH201805)。

摘　　要：目的:探讨眼眶淋巴瘤多模态影像学特征。方法:回顾性分析27例经病理证实为眼眶淋巴瘤患者的治疗前MRI、CT增强扫描及^(18)F-FDG PET/CT影像。评估内容包括病灶的MRI特征、CT增强扫描特征及最大标准摄取值(SUVmax)。结果:总共收集27例(34眶)患者,其中25例(31眶)行眼眶MR扫描,10例(13眶)行CT增强扫描及^(18)F-FDG PET/CT扫描。病变多位于眶隔前区(15.38%)、泪腺区(23.08%)及肌锥区(21.54%)。病灶在压脂T_(2)WI上,11例呈均匀稍高信号,13例呈等信号,1例呈混杂高信号;压脂T_(1)WI上,24例呈等信号,1例呈稍低信号;压脂T_(1)WI增强扫描上,15例呈中度均匀强化,8例为轻度均匀强化,2例为不均匀强化;7例可见骨质破坏。10例行CT增强扫描及^(18)F-FDG PET/CT扫描患者中,病理组织类型为黏膜相关淋巴组织边缘区B细胞(MALT)淋巴瘤5例,弥漫大B细胞淋巴瘤(DLBCL)5例,其中1例DLBCL患者在CT上表现为不均匀密度,其余9例表现为均匀密度。两种病理类型病灶的△CT值差异无统计学意义(统计值0.60,P>0.05)。DLBCL与MALT淋巴瘤病灶的SUVmax差异具有统计学意义[6.40(5.40~7.10)vs.11.40(9.63~25.60),P=0.009]。结论:眼眶淋巴瘤病变多位于眶隔前区、泪腺区及肌锥区。MRI上病灶压脂T_(1)WI多呈等信号,压脂T_(2)WI呈等或稍高信号,增强扫描呈轻到中度强化;在CT上表现为均匀密度,增强扫描呈轻到中度强化,病灶的强化程度对鉴别DLBCL和MALT淋巴瘤无帮助。在^(18)F-FDG PET/CT中,DLBCL的SUVmax较高,病灶的SUVmax有助于鉴别DLBCL和MALT淋巴瘤。Objective:To explore multimodal imaging features of orbital lymphoma.Methods:The MRI,contrast-enhanced CT scans and ^(18)F-FDG PET/CT of 27 patients with pathologically confirmed orbital lymphoma before treatment were retrospectively analyzed.The evaluation contents included the lesion's MRI characteristics,CT enhancement characteristics and maximum standard uptake value(SUVmax).Results:Among the 27 patients(34 orbits),25 patients(31 orbits)underwent orbital MR scans,and 10 patients(13 orbits)underwent contrast-enhanced CT scans and ^(18)F-FDG PET/CT scans.The lesions were primarily located in the preseptal space(15.38%),lacrimal gland region(23.08%)and extraocular muscle cone region(21.54%).On fat suppressed T_(2)-weighted images,11 cases showed homogeneous slight hyperintensity,13 cases showed isointensity,and 1 case was heterogeneous hyperintensity.On fat suppressed T_(1)-weighted images,24 cases showed isointensity,and 1 case showed slight hypointensity.On contrast-enhanced fat suppressed T_(1)-weighted images,15 cases showed moderate homogeneous enhancement,8 cases showed mild homogeneous enhancement,and 2 cases showed heterogeneous enhancement.7 cases showed bone destruction.Among the 10 patients who underwent contrast-enhanced CT scans and ^(18)F-FDG PET/CT,5 cases were mucosa-associated lymphoid tissue(MALT)lymphoma and 5 cases were diffuse large B-cell lymphoma(DLBCL).1 case of DLBCL showed heterogeneous density on CT,and the remaining 9 patients showed homogeneous density.There was no significant difference in the△CT value of orbital lesions between MALT and DLBCL(P=0.60,P>0.05).The SUVmax of the lesions was significantly different between DLBCL and MALT lymphoma[6.40(5.40~7.10)vs.11.40(9.63~25.60,P=0.009].Conclusion:The lesions are mostly located in the preseptal space,lacrimal gland region and extraocular muscle cone region.The lesions show isointensity on fat suppressed T_(1)-weighted images,isointensity or slightly hyperintensity on fat suppressed T_(2)-weighted images,and mild to moderate enhance

关 键 词：眼眶淋巴瘤 眼眶肿瘤 磁共振成像 体层摄影术 X线计算机 诊断 

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]