眼眶淋巴瘤临床及影像学分析

Analysis of clinical features and imagines in orbital lymphoma

目的 通过分析眼眶淋巴瘤的临床表现以及B超、CDI、CT、MRI等影像学表现,探讨其对于眼眶淋巴瘤诊断和鉴别诊断的价值.方法 对53例56只眼眼眶淋巴瘤进行回顾性分析.结果 眼眶淋巴瘤可累及眼眶内不同区域,大部分眼眶淋巴瘤表现为眶区肿物,眼球运动受限,部分表现为眼睑、结膜水肿及眼球突出等.53例（56只眼）行B超探查,42只眼显示为形状不规则,42只眼内回声少,31只眼内回声不均匀,11只眼显示眼球受压变形.40例（43只眼）行CDI探查,19只眼显示病变内血流信号丰富,14只眼仅见少许血流信号.49例（52只眼）行cT扫描,41只眼显示病变形状不规则,34只眼显示病变边界清楚,29只眼内密度均匀,25只眼显示病变与眼球呈＂铸造样＂,3只眼可见骨破坏.15例（15只眼）行MRI检查,11只眼显示为T1WI中等信号强度,T2WI中等偏高信号强度,6只眼行强化MRI检查均可被中度强化.结论 临床表现以及影像学检查对于眼眶淋巴瘤的诊断和鉴别诊断具有重要价值.

Objective To investigate the value of ultrsonography,colour doppler image,CT and MRI on diagnosis and differential diagnosis of orbital lymphoma.Methods The clinical and imageologic features of 53 cases（56 eyes）orbital lymphoma were analyzed.Results Any part of orbits could be involved.Most cases showed orbital masses,limitation of ocular movement.Some cases were with visual loss,conjunctiva and lid swelling and exophthalmos.Fifty-three cases（56 eyes）with B-scan ultrasonography revealed irregular shape in 42 eyes,less reflective in 42 eyes,uniformed reflective in 31 eyes,eyeballs were compressed in 11 eyes.Forty cases（43 eyes）of orbital lymphoma were detected with CDI,in which rich blood flow signal were showed in 19 eyes,less blood flow signal in 14 eyes.CT scan were done in 49 cases（52 eyes）,in which,showed irregular shape in 41 eyes,regular border in 34 eyes,uniform density in 29 eyes,touched closely with the globe in 25 eyes,orbital walls showed bone dystrophy in 3cases.Fifteen cases（15 eyes）were examined with MRI,11 cases showed isointensity signal on TIWI,slight hyperintense signal in T2WI.Six cases were enhanced moderately by GPDA.Conclusions Clinical and imageologic feature are valuable on the diagnosis and differential diagnosis of orbital lymphoma.