泪腺腺样囊性癌的CT和MRI诊断

CT and MRI diagnosis of adenocystic carcinoma of the lacrimal gland

目的探讨CT和MRI对泪腺腺样囊性癌的诊断价值。方法回顾性分析12例经病理证实的泪腺腺样囊性癌的影像学资料,9例行CT检查,11例行MRI检查。结果肿瘤发生在泪腺眶部,呈不规则扁长形9例,椭圆形3例;沿肌锥外间隙向眶尖浸润生长,与外直肌分界不清9例;8例边缘不规则。9例CT表现为不均匀等密度或略高密度,伴眶壁骨质“虫蚀样”或广泛破坏6例,眶壁受压凹陷变形2例,骨质增生硬化4例。MR检查11例,T1WI呈等信号8例,低信号3例,信号不均匀,T2WI均为不均匀高信号,增强后肿块不均匀明显强化。肿瘤侵及颅内、颞窝和海绵窦6例。结论泪腺腺样囊性癌的CT和MRI表现具有一定特征,CT和MRI结合可以提高病变诊断的准确性。

Objective To study the role of CT and MR imaging in diagnosing adenocystic carcinoma of the lacrimal gland. Methods The imaging manifestations of 12 cases with lacrimal gland adenocystic carcinoma pathologically confirmed were retrospectively reviewed , 9 cases were performed with CT scan, 11 cases with MRI scan. Results The lesions originated in the orbital lobe of the lacrimal gland, showed irregular oblong shape in 9 cases, oval shape in 3 cases; infiltrated in the extraconal space to the orbital apex having a ill-defined margin with the lateral rectus muscle in 9 cases; irregular margins were seen in 8 cases. CT scanning performed in 9 patients showed heterogeneous iso-density or mildly hyper-density mass with orbital bone erosion or destruction in 6 cases, bone deformity in 2 cases, bone sclerosis in 4 cases. MR Tl-weighted imaging demonstrated heterogeneous isointense signal in 8 cases and hypointense signal in 3 cases. MR T2-Weighted imaging demonstrated heterogeneous hyperintense signal in all cases. Postcontrast MR imaging showed heterogeneous marked contrast enhancement in all cases. Intracranial, temporal fossa and cavernous extension was seen in 6 cases. Conclusion CT and MR imaging could reveal characteristic findings of adenocystic carcinoma of the lacrimal gland. The application of both could improve the diagnostic accuracy of the lesions.