泪囊区占位性病变43例病理及影像学分析

Pathology and imaging analysis of 43 cases with lacrimal sac lesions

目的探讨泪囊区占位性病变的病理组织学类型与影像学表现的相互关系。方法收集10年间诊治的43例泪囊区占位性病变患者的临床资料和组织标本切片，回顾性分析其病理类型及影像学表现。结果囊性占位性病变15例，实体占位性病变28例。囊性占位cT多表现为边界清楚，内密度可均匀或不均，囊壁密度略高；B超多表现为圆形或类圆形，后界回声可显示，具有可压缩性；彩色多普勒血流成像（CDFI）多显示病变内无彩色血流信号。实体性占位cT多表现为边界不清，软组织密度，病变周围骨质常有破坏；B超多表现为不规则占位，内回声多不均匀，无可压缩性；CDFI因不同的病理类型显示红蓝信号强弱不等。结论泪囊区囊性占位性病变以良性居多，实体性占位性病变以恶性肿瘤居多。超声、彩色多普勒及cT等影像学技术对术前判断泪囊区占位性病变的性质、病变范围有着重要的临床意义。

Objective To investigate the relation between pathology and imaging findings in the lacrimal sac lesions. Methods Collected clinical material and samples from slices of 43 patients with lacrimal sac lesions, and retrospectively analyzed the pathological types and imaging findings. Results Fifteen cases of cystic lesions, 28 patients of solid lesions were reviewed. Clear boundary, even or uneven density and high density of cystic wall in CT imaging of cystic lesion, in B ultrasound, circular shape could be seen and the lesions could be compressed, no signal of blood flow in the cystic lesion with CDFI. However, for solid lesions, the boundary of the lesions was not clear, sometimes combined destruction of bone in CT imaging of solid lesion. In B ultrasound, different shapes could be seen and the lesions could not be compressed according to different pathological types, blood flow signal maybe different in CDFI. Conclusions The majority of lacrimal sac cystic lesions are benign, but solid lesions are inclined to malignant tumors. Therefore, the imaging techniques including CT, B ultrasound, and Color doppler ultrasound have the significant value in the diagnosis or prognosis of lacrimal sac lesions.