泪腺导管囊肿影像表现及临床特点分析

Imaging manifestations and clinical characteristics of lacrimal duct cyst

目的探讨分析泪腺导管囊肿的CT、MRI影像表现特征及其临床特点,提高对该病的影像诊断正确率。方法回顾性病例研究。分析我院2017年1月至2023年2月经手术病例证实的18例(18只眼)泪腺导管囊肿的临床特点、病理学、CT和MRI影像表现等资料。结果18例泪腺导管囊肿均为单侧发病,均为首发患者,有眼部病史患者4例,伴发眼部疼痛、肿胀、眼磨等不适症状患者12例,右眼眶13例,左眼眶5例,15位于泪腺睑部,1例位于泪腺眶部,1例位于上睑穹隆部,1例位于泪囊窝,18例均为单侧发病。18例行CT平扫,低密度(CT值030HU)13例,软组织密度(CT值3080HU)5例,其内均未见钙化。18例行MRI平扫及增强扫描,其中T1WI呈低信号者13例,等信号者5例,DWI均未见受限改变,增强扫描13例未见强化,5例可见囊壁稍增厚、毛糙、强化。病理提示18例泪腺导管囊肿中,3例可见炎性细胞。结论泪腺导管囊肿好发于中老年患者,男性稍多见,临床症状多以眼部肿胀、疼痛、眼磨多见,CT低密度、MRI呈长T1长T2、增强无强化是泪腺导管囊肿的特征影像表现。

Objective To explore and analyze the computed tomography(CT)and magnetic resonance imaging(MRI)features and clinical features of lacrimal duct cysts,in order to improve the accuracy of imaging diagnosis of this disease.Methods A retrospective case series study.The clinical characteristics,pathology,CT and MRI imaging findings of 18 cases of lacrimal duct cysts confirmed by surgical cases in our hospital from January 2017 to February 2023 were analyzed.Results All 18 cases of lacrimal duct cysts were unilateral,and they were all newly diagnosed patients.There were 4 patients with a history of eye diseases,12 patients with accompanying symptoms such as eye pain,swelling,and eye wear,13 patients with right orbit,5 patients with left orbit,15 patients with lacrimal gland eyelid,1 patient with lacrimal gland orbit,1 patient with upper eyelid fornix,1 patient with lacrimal sac fossa.18 cases underwent CT plain scan,including 13 cases with low density(CT value 0-30HU)and 5 cases with soft tissue density(CT value 30-80HU),all of which showed no calcification.18 cases underwent MRI plain and enhanced scans,including 13 cases with low signal on T1WI and 5 cases with equal signal.DWI showed no limited changes,13 cases showed no enhancement on enhanced scans,and 5 cases showed slight thickening,roughness,and enhancement of the cyst wall.Pathological findings suggest that inflammatory cells can be seen in 3 out of 18 cases of lacrimal duct cysts.Conclusions Lacrimal duct cysts are more common in middleaged and elderly patients,slightly more common in males,and clinical symptoms are mostly eye swelling,pain,and eye wear.The characteristic imaging manifestations of lacrimal duct cysts are low density CT,long T1 and T2 on MRI,and no enhancement.