CT显示双侧泪腺肿大的眼眶病分析

Analysis of the orbital diseases manifested bilateral lacrimal gland enlargement on CT

目的 分析和探讨不同疾病所致双侧泪腺肿大的临床表现和影像特征,为临床诊断和治疗提供依据.方法 回顾性分析在治疗的伴有双侧泪腺肿大的眼眶病患者的临床资料,对其不同眼眶疾病所表现的双侧泪腺肿大进行临床和影像分析.结果 共收治82例双侧泪腺肿大病例,依患病率高低依次为泪腺炎性假瘤,甲状腺相关眼病,泪腺脱垂伴肿大,非霍奇金淋巴瘤,良性淋巴上皮性病变,泪腺结核,转移性泪腺恶性肿瘤和白血病,泪腺结节病.不同疾病所致的双侧泪腺肿大各有其不同的临床表现和影像特征.结论 导致双侧泪腺肿大的疾病主要为泪腺炎症性或自身免疫相关性疾病,少数为原发性或转移性恶性肿瘤,除甲状腺相关眼病具有特征性眼征和影像学特点较易诊断外,其它伴有双侧泪腺肿大的眼眶病需要根据病史、临床特征和影像学表现进行鉴别诊断.

Objective To analyze and study the disease that caused bilateral lacrimal gland enlargement,so as to provide evidence for clinical diagnosis and treatment. Methods Retrospective case analysis.The patients whose lcarimal gland enlargements on CT were collected,clinical manifest and image were analyzed.Results There were 82 cases of patients were collected.According to the prevalence rate,the sequencing was lacrimal gland inflammatory pseudo tumor,thyroid associated ophthalmology （TAO）,dislocation of lacrimal gland accompanied enlargement,non-Hodgkin disease,benign lymphoepithelial lesion （BLEL）,tuberculosis of lacrimal gland,metastatic malign tumor of lcarimal gland,leukemia,sarcoidosis of lacrimal gland.Each disease had its own character in clinical and imaging features. Conclusions The majority of diseases that cause bilateral lacrimal gland enlargement are inflammatory diseases or autoimmune diseases,while few primary or metastatic malignant tumors.Expect TAO has characteristic eye sign and imagine that easy to be diagnosed,the other orbit diseases need combines with clinical history,symptom and imagine feature to be differential diagnosed