摘要
目的探讨眼眶原发性淋巴瘤的磁共振成像(MRI)表现,提高该病的影像诊断水平。方法回顾性分析2014年1月至2021年4月于本院经手术后病理及免疫组织化学染色证实的23例眼眶原发性淋巴瘤患者的临床资料。全部患者均行MRI平扫及增强扫描,分析其MRI影像学特征(主要包括病变部位、病变形态、侵犯部位、MRI信号及其与邻近结构的关系)。结果23例眼眶原发性淋巴瘤患者中,病变部位单侧占比高于双侧占比(P<0.05);病灶形态为局限性或弥漫性;侵犯部位为肌锥外间隙和跨肌锥内外占比高于肌锥内间隙占比(P<0.05)。所有患者MRI平扫T_(1)加权成像(T_(1)WI)均同眼外肌信号一致呈等信号,T_(2)加权成像(T_(2)WI)及短T_(1)反转恢复(STIR)序列以稍高于眼外肌信号为主,少数与眼外肌信号相同(P<0.05);增强MRI成像以轻度均匀强化和轻、中度欠均匀强化为主,极少数呈与眼外肌信号一致的中度均匀强化(P<0.05)。病变累及眶隔前部占比高于未累及眶隔前部占比,累及眼外肌包绕、分界不清占比高于未侵犯、受压占比,累及视神经未受包绕占比高于受包绕占比,累及眼球未受包绕占比高于受包绕占比,眼眶骨质破坏占比低于无眼眶骨质破坏占比,眶外侵犯占比低于无眶外侵犯占比(P<0.05)。结论眼眶原发性淋巴瘤的MRI表现有一定的特征性,单侧多见,病灶呈局限性或弥漫性,以侵犯肌锥外间隙和跨肌锥内外为主,好发于眶隔前部,并向眶内侵犯;较多包绕眼外肌生长,少见包绕视神经、眼球生长,少见骨质破坏和眶外侵犯;T_(2)WI及STIR序列MRI信号稍高于眼外肌,增强扫描呈轻度至中度、均匀或欠均匀强化。
Objective To investigate the magnetic resonance imaging(MRI)findings of primary orbital lymphoma and to improve the diagnostic level of this disease.Methods The clinical data of 23 patients with primary orbital lymphoma confirmed by postoperative pathology and immunohistochemical staining in our hospital from January 2014 to April 2021 were retrospectively analyzed.All patients underwent MRI plain scan and enhanced scan,and the MRI imaging features(mainly including lesion location,lesion morphology,invasion site,MRI signal and its relationship with adjacent structures)were analyzed.Results In 23 cases of primary orbital lymphoma,the proportion of unilateral lesions was higher than that of bilateral lesions(P<0.05);the lesions morphology were localized or diffuse;the proportion of external muscle cone space and the internal and external transmuscular cone was higher than that of internal muscle cone space(P<0.05).The T_(1)-weighted imaging(T_(1)WI)of plain MRI of all patients showed equal signal with the signal of extraocular muscles,the T_(2)-weighted imaging(T_(2)WI)and short T_(1) inversion recovery(STIR)sequence were slightly higher than the signal of extraocular muscles,and a few were the same as the signal of extraocular muscles(P<0.05);the enhanced MRI imaging showed mild homogeneous enhancement and mild and moderate under homogeneous enhancement were the main findings,and few of them showed moderate homogeneous enhancement consistent with the signal of extraocular muscles(P<0.05).The proportion of lesions involving the anterior orbital septum was higher than that without involving the anterior orbital septum,the proportion of lesions involving the extraocular muscles with wrapping and unclear demarcation was higher than that without encroaching and compression,the proportion of lesions involving optic nerve without wrapping was higher than that with wrapping,the proportion of lesions involving the eyeball without wrapping was higher than that with wrapping,the proportion of orbital bone destruction was lower than that without orbital bone destruction,and the proportion of out of frame violations was lower than that of non frame violations(P<0.05).Conclusion The MRI findings of primary orbital lymphoma have certain characteristics,which are mostly unilateral.The lesions are localized or diffuse,mainly invading the external muscle cone space and the internal and external transmuscular cone.The lesions are more likely to occur in the anterior part of the orbital septum and invade into the orbit.Extraocular muscle growth is more common,optic nerve and eyeball growth are less common,and bone destruction and extraorbital invasion are less common.The MRI signal of T_(2)WI and STIR sequence is slightly higher than that of extraocular muscles,and the enhancement scan showed mild to moderate homogeneous enhancement and under homogeneous enhancement.
作者
李飞
刘锦琳
田强
LI Fei;LIU Jinlin;TIAN Qiang(Radiology Department,Tangdu Hospital,Air Force Military Medical University,Xi'an 710038,China)
出处
《临床医学研究与实践》
2022年第36期5-8,13,共5页
Clinical Research and Practice
基金
国家自然科学基金资助项目(No.81801655)。
关键词
眼眶原发性淋巴瘤
磁共振成像
影像诊断
primary orbital lymphoma
magnetic resonance imaging
imaging diagnosis
