常规超声及超声造影在诊断眼眶前部占位性病变中的价值

The value of conventional and contrast-enhanced ultrasound in the diagnosis of tumors in front of the orbit equator

目的探讨常规超声及超声造影在眼眶前部（眼赤道部以前）占位性病变中的价值。方法回顾性分析我院收治的各类眼眶前部占位性病变156只眼（133例患者）的常规超声及超声造影资料。其中，囊肿性病变（表皮样囊肿、皮样囊肿、皮脂腺囊肿及黏液囊肿）26例，血管瘤29例（3（1只眼），炎性假瘤13例（16只眼），泪腺多形性腺瘤11例，淋巴上皮病3例（5只眼），恶性淋巴瘤36例（53只眼）．睑板腺癌5例．泪腺腺样囊性癌4例，恶性黑色素瘤3例，基底细胞癌3例。全部病例经手术病理证实或经临床治疗后治愈证实。结果囊肿性病变超声造影表现为仅周围可见增强。内部始终无增强。良性肿块超声造影多表现为慢进慢退，向心性增强，达峰时呈高增强，增强后大小无变化；恶性肿块多表现为快进快退，达峰时呈高增强，增强不均匀，增强后体积较二维超声增大。眼眶海绵状血管瘤、静脉性血管瘤、多形性腺瘤、恶性淋巴瘤二维超声及超声造影多有特征性表现。结论结合二维超声及超声造影检查可以更准确地完成眼眶前部占位性病变的定性诊断。

Objective To explore the value of conventional and contrast-enhanced ultrasound（CEUS） in the diagnosis of tumors in front of the orbit equator. Methods Clinical data included conventional ultrasound and CEUS image of 133 cases （156 eyes） with orbital lesions were analyzed retrospectively. All lesions were confirmed by surgical pathology or clinical cure, which included 26 cases of cystic lesions （epidermoid cysts, dermoid cysts, sebaceous cysts and mucous cysts）, 29 cases （30 eyes） of orbital hemangioma, 13 cases （16 eyes） of inflammatory pseudotumor, 11 cases of lacrimal gland pleomorphic adenoma, 3 cases （5 eyes） of lymphoepithelial lesion, 36 cases （53 eyes） of malignant lymphoma, 5 cases of meibomian gland carcinoma, 4 cases of lacrimal gland adenoid cystic carcinoma, 3 cases of malignant melanoma and 3 cases of basal cell carcinoma. Results CEUS of benign cystic lesions showed the tumors were enhanced inhomogenously. Most CEUS of benign tumours displayed ＂slow in and slow out＂, and high enhancement when reached the peak but the size of images had no change. While CEUS of malignant tumours showed ＂fast in and fast out＂, homogeneous or inhomogeneous high enhancement and ill-defined or irregular shape, and volume increased compared to two-dimensional ultrasound when reached the peak. Some other former district orbital lesions, such as cystic lesion, cavernous hemangioma, pleomorphic adenoma and malignant lymphoma, had their own ultrasound features. Conclusions CEUS combines with conventional ultrasound may contribute to the qualitative diagnosis of tumors in front of the orbit equator.