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目的:通过对眼眶炎性假瘤B超、CT、MRI及彩色多普勒成像(CDI)检查,探讨影像学检查对眼眶炎性假瘤诊断和鉴别诊断的价值。方法:对245例(275只眼)眼眶炎性假瘤进行回顾性分析。结果:根据肿瘤的组织学特征不同,超声探查和CT扫描具有多样的表现,弥漫性淋巴细胞浸润型炎性假瘤B超显示为眶内低回声、透声性强的占位病变,而纤维增生型炎性假瘤则多为低回声、透声性差、边界不清之肿物,且CT扫描可见肿物与眼球接触紧密,呈“铸造样”改变。根据病变累及的部位不同,又分为炎性肿块、肥大性肌炎、泪腺炎等。需要鉴别的疾病包括甲状腺相关眼病、颈动脉-海绵窦瘘、眼外肌豚囊尾蚴、泪腺混合瘤、泪腺腺样囊性癌以及眼眶恶性肿瘤。结论:影像学检查对于眼眶炎性假瘤的诊断、鉴别诊断具有重要价值。
Objective: To evaluate the value of imaging examination in the diagnosis and differential diagnosis of orbital inflammatory pseudotumor by examining B-mode ultrasound, CT, MRI and color Doppler imaging (CDI) of orbital inflammatory pseudotumor. Methods: 245 cases (275 eyes) of orbital inflammatory pseudotumor were retrospectively analyzed. Results: According to the different histological features of the tumor, ultrasound and CT scan showed various manifestations. Diffuse lymphocytic infiltrating pseudotumor B-mode showed intraorbital hypoechoic and strong penetrable lesions, while fibrous Proliferative inflammatory pseudotumor is mostly hypoechoic, poor sound transmission, unclear boundaries of the tumor, and CT scan visible mass and eye contact closely, was “cast like” change. According to the lesion involved in different parts, is divided into inflammatory mass, hypertrophic myositis, lacrimal gland inflammation and so on. Diseases that need to be identified include thyroid-associated ophthalmopathy, carotid-cavernous fistula, extraocular muscle cysticercus, mixed lacrimal gland tumor, adenoid cystic carcinoma of the lacrimal gland, and orbital malignancy. Conclusion: The imaging examination is of great value in the diagnosis and differential diagnosis of orbital inflammatory pseudotumor.