泪腺肿瘤的彩色多普勒超声诊断研究
发布时间：2018-09-01 05:42
【摘要】：目的 泪腺区肿瘤种类繁多,本文总结泪腺肿瘤的临床特点,分析不同肿瘤的彩色多普勒成像的声学特征和血流特点。对照病理学结果,研究泪腺肿瘤的彩色多普勒超声图像表现与病理的相关性,为临床诊断提供帮助。 方法 选择2008年1月到2013年10月期间天津市眼科医院经病理组织学证实的泪腺肿瘤患者72例。分析患者的临床症状、体征、性别、年龄等资料,同时进行彩色多普勒超声检查,记录各项超声声像图指标,如病变的位置、形状、边界、内回声强弱、分布是否均匀及声衰减；血流信号的丰富程度、位置、分布、形状、血流参数等指标,进行归纳总结。与病理结果进行对照,研究泪腺肿瘤的彩色多普勒超声特点。 结果 72例患者中,男性29例(40.28%),女性43例(59.72%)；平均年龄42.74±16.87岁,最大年龄78岁,最小年龄13岁,中位年龄46岁；单眼66例(91.66%),双眼6例(8.34%)；合计78只眼,右眼34只(43.59%),左眼44只(56.41%)；平均病程14.99±16.09月,最长8年,最短半个月；眼球突出55例(76.39%)、泪腺区发现肿物51例(70.83%)、眼睑肿胀42例(58.33%)、疼痛21例(29.17%)、眼球运动受限38例(52.78%)、复视12例(16.67%)、视力下降19例(26.39%)、上睑下垂16例(22.22%)。其中最常见的症状是眼球突出(76.39%)和泪腺区发现肿物(70.83%)；术后病理上皮性肿瘤共46例(63.89%),其中多形性腺瘤32例(44.44%),腺样囊性癌11例(15.28%),腺癌3例(4.17%),非上皮性肿瘤(非霍奇金淋巴瘤)共14例(19.44%),类肿瘤(炎性假瘤)共12例(16.67%)。 B型超声显示泪腺多形性腺瘤病变形状为圆形或类圆形,边界清楚,内回声均匀；腺样囊性癌病变形状为扁平形,边界清楚,内回声较少,声衰减中等；腺癌为类圆形或不规则形占位病变,边界不清楚,内回声中等,后界为弱回声；非霍奇金淋巴瘤形状不规则,边界不清楚,内回声较低,声衰减不显著；炎性假瘤为不规则形占位病变,边界清楚,但不整齐,低回声,声衰减显著。CDI检测泪腺多形性腺瘤内部无血流信号或血流信号不丰富,而其他四种肿瘤内部的血流信号丰富。测得多形性腺瘤的PSV11.06±5.13cm/S,EDV1.94±1.17cm/s,R10.49±0.21；腺样囊性癌的PSV16.99±7.13cm/s,EDV5.75±2.11cm/s,R10.75±0.15；非霍奇金淋巴瘤的PSV17-34±7.66cm/s,EDV5.47±3.19cm/s,RI0.65±0.11；炎性假瘤的PSV18.66±9.86cm/s,EDV5.09±3.14cm/S,RI0.66±0.13。将泪腺多形性腺瘤、腺样囊性癌、非霍奇金淋巴瘤、炎性假瘤,这四种肿瘤的血流参数的PSV.EDV和RI值进行统计比较,发现有显著性差异。 结论 泪腺肿瘤的彩色多普勒超声征象与病理组织学特点密切相关。所以,利用彩色多普勒超声可大致推断泪腺肿瘤的病理组织学类型。 彩色多普勒超声具有操作简便、无创、重复性好、可动态下观察显示病变内血流动力学资料的特点。可结合CT或MRI检查对肿瘤进行定性诊断及鉴别诊断,对于泪腺肿瘤的诊断和治疗具有指导意义。
[Abstract]:Objective to summarize the clinical features of lacrimal gland tumors and to analyze the acoustic and blood flow characteristics of different tumors in the lacrimal gland region. To study the correlation between color Doppler ultrasonography and pathology of lacrimal gland tumor. Methods 72 patients with lacrimal gland tumor confirmed by histopathology in Tianjin Ophthalmology Hospital from January 2008 to October 2013 were selected. The clinical symptoms, signs, gender and age of the patients were analyzed. At the same time, color Doppler ultrasound was performed to record the ultrasonic image parameters, such as the location, shape, boundary, internal echo intensity and intensity of the lesions. The abundance, location, distribution, shape and blood flow parameters of blood flow signal were summarized. The color Doppler ultrasound features of lacrimal gland tumors were studied. Results among the 72 patients, 29 (40.28%) were male and 43 (59.72%) were female, the mean age was 42.74 卤16.87 years, the maximum age was 78 years, the minimum age was 13 years, the median age was 46 years old, 66 cases (91.66%), 6 eyes (8.34%), 78 eyes. 34 eyes (43.59%), 44 eyes (56.41%), the average course of disease was 14.99 卤16.09 months, the longest was 8 years, the shortest half month; There were 55 cases (76.39%) with exophthalmos, 51 cases (70.83%) with lacrimal gland area, 42 cases (58.33%) with eyelid swelling, 21 cases (29.17%) with pain, 38 cases (52.78%) with limited eye movement, 12 cases (16.67%) with diplopia, 19 cases (26.39%) with visual acuity loss, 16 cases (22.22%) with ptosis. The most common symptoms were exophthalmos (76.39%) and lacrimal gland mass (70.83%). There were 46 cases (63.89%) of pathological epithelial tumors, including 32 cases of pleomorphic adenoma (44.44%), 11 cases of adenoid cystic carcinoma (15.28%), 3 cases of adenocarcinoma (4.17%), 14 cases (19.44%) of non-epithelial tumor (non-Hodgkin 's lymphoma) and 12 cases (16.67%) of neoplasm (inflammatory pseudotumor). B-mode ultrasound showed that the lesions of lacrimal gland pleomorphic adenoma were round or round in shape. The shape of adenoid cystic carcinoma is flat shape, the boundary is clear, the inner echo is less, the sound attenuation is moderate, the adenocarcinoma is round or irregular occupying lesion, the boundary is unclear, the inner echo is medium, and the posterior boundary is weak echo. The shape of non-Hodgkin 's lymphoma is irregular, the boundary is unclear, the internal echo is low, the sound attenuation is not significant, the inflammatory pseudotumor is irregular occupying lesion, the boundary is clear, but the boundary is irregular, the echo is low. There was no or no blood flow signal in the lacrimal gland pleomorphic adenoma, while the other four tumors had abundant blood flow signal. The PSV11.06 卤5.13 cm / s EDV of pleomorphic adenoma was 1.94 卤1.17 cm / s R10.49 卤0.21; the PSV16.99 of adenoid cystic carcinoma was 5.75 卤2.11 cm / s EDV 5.75 卤2.11 cm / s EDV; the PSV17-34 卤7.66 cm / s EDV of non-Hodgkin 's lymphoma was 5.47 卤3.19 cm / r = 0.65 卤0.11; the PSV18.66 卤9.86 cm / s EDV of inflammatory pseudotumor was 5.09 卤3.14 cm / r = 0.66 卤0.13. The PSV.EDV and RI values of pleomorphic adenoma, adenoid cystic carcinoma, non-Hodgkin 's lymphoma and inflammatory pseudotumor were compared. Conclusion Color Doppler ultrasound findings of lacrimal gland tumors are closely related to histopathological features. Therefore, the histopathological types of lacrimal gland tumors can be inferred by color Doppler ultrasound. Color Doppler ultrasound is simple, noninvasive and reproducible. It can be used to observe and display hemodynamic data dynamically. It can be combined with CT or MRI to make qualitative diagnosis and differential diagnosis of the tumor, which is of guiding significance for the diagnosis and treatment of lacrimal gland tumor.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.7;R445.1
本文编号：2216282
[Abstract]:Objective to summarize the clinical features of lacrimal gland tumors and to analyze the acoustic and blood flow characteristics of different tumors in the lacrimal gland region. To study the correlation between color Doppler ultrasonography and pathology of lacrimal gland tumor. Methods 72 patients with lacrimal gland tumor confirmed by histopathology in Tianjin Ophthalmology Hospital from January 2008 to October 2013 were selected. The clinical symptoms, signs, gender and age of the patients were analyzed. At the same time, color Doppler ultrasound was performed to record the ultrasonic image parameters, such as the location, shape, boundary, internal echo intensity and intensity of the lesions. The abundance, location, distribution, shape and blood flow parameters of blood flow signal were summarized. The color Doppler ultrasound features of lacrimal gland tumors were studied. Results among the 72 patients, 29 (40.28%) were male and 43 (59.72%) were female, the mean age was 42.74 卤16.87 years, the maximum age was 78 years, the minimum age was 13 years, the median age was 46 years old, 66 cases (91.66%), 6 eyes (8.34%), 78 eyes. 34 eyes (43.59%), 44 eyes (56.41%), the average course of disease was 14.99 卤16.09 months, the longest was 8 years, the shortest half month; There were 55 cases (76.39%) with exophthalmos, 51 cases (70.83%) with lacrimal gland area, 42 cases (58.33%) with eyelid swelling, 21 cases (29.17%) with pain, 38 cases (52.78%) with limited eye movement, 12 cases (16.67%) with diplopia, 19 cases (26.39%) with visual acuity loss, 16 cases (22.22%) with ptosis. The most common symptoms were exophthalmos (76.39%) and lacrimal gland mass (70.83%). There were 46 cases (63.89%) of pathological epithelial tumors, including 32 cases of pleomorphic adenoma (44.44%), 11 cases of adenoid cystic carcinoma (15.28%), 3 cases of adenocarcinoma (4.17%), 14 cases (19.44%) of non-epithelial tumor (non-Hodgkin 's lymphoma) and 12 cases (16.67%) of neoplasm (inflammatory pseudotumor). B-mode ultrasound showed that the lesions of lacrimal gland pleomorphic adenoma were round or round in shape. The shape of adenoid cystic carcinoma is flat shape, the boundary is clear, the inner echo is less, the sound attenuation is moderate, the adenocarcinoma is round or irregular occupying lesion, the boundary is unclear, the inner echo is medium, and the posterior boundary is weak echo. The shape of non-Hodgkin 's lymphoma is irregular, the boundary is unclear, the internal echo is low, the sound attenuation is not significant, the inflammatory pseudotumor is irregular occupying lesion, the boundary is clear, but the boundary is irregular, the echo is low. There was no or no blood flow signal in the lacrimal gland pleomorphic adenoma, while the other four tumors had abundant blood flow signal. The PSV11.06 卤5.13 cm / s EDV of pleomorphic adenoma was 1.94 卤1.17 cm / s R10.49 卤0.21; the PSV16.99 of adenoid cystic carcinoma was 5.75 卤2.11 cm / s EDV 5.75 卤2.11 cm / s EDV; the PSV17-34 卤7.66 cm / s EDV of non-Hodgkin 's lymphoma was 5.47 卤3.19 cm / r = 0.65 卤0.11; the PSV18.66 卤9.86 cm / s EDV of inflammatory pseudotumor was 5.09 卤3.14 cm / r = 0.66 卤0.13. The PSV.EDV and RI values of pleomorphic adenoma, adenoid cystic carcinoma, non-Hodgkin 's lymphoma and inflammatory pseudotumor were compared. Conclusion Color Doppler ultrasound findings of lacrimal gland tumors are closely related to histopathological features. Therefore, the histopathological types of lacrimal gland tumors can be inferred by color Doppler ultrasound. Color Doppler ultrasound is simple, noninvasive and reproducible. It can be used to observe and display hemodynamic data dynamically. It can be combined with CT or MRI to make qualitative diagnosis and differential diagnosis of the tumor, which is of guiding significance for the diagnosis and treatment of lacrimal gland tumor.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.7;R445.1
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