淚腺腫瘤的彩色多普勒超聲診斷研究
發(fā)布時間：2018-09-01 05:42
【摘要】：目的 淚腺區(qū)腫瘤種類繁多,本文總結(jié)淚腺腫瘤的臨床特點,分析不同腫瘤的彩色多普勒成像的聲學(xué)特征和血流特點。對照病理學(xué)結(jié)果,研究淚腺腫瘤的彩色多普勒超聲圖像表現(xiàn)與病理的相關(guān)性,為臨床診斷提供幫助。 方法 選擇2008年1月到2013年10月期間天津市眼科醫(yī)院經(jīng)病理組織學(xué)證實的淚腺腫瘤患者72例。分析患者的臨床癥狀、體征、性別、年齡等資料,同時進行彩色多普勒超聲檢查,記錄各項超聲聲像圖指標(biāo),如病變的位置、形狀、邊界、內(nèi)回聲強弱、分布是否均勻及聲衰減；血流信號的豐富程度、位置、分布、形狀、血流參數(shù)等指標(biāo),進行歸納總結(jié)。與病理結(jié)果進行對照,研究淚腺腫瘤的彩色多普勒超聲特點。 結(jié)果 72例患者中,男性29例(40.28%),女性43例(59.72%)；平均年齡42.74±16.87歲,最大年齡78歲,最小年齡13歲,中位年齡46歲；單眼66例(91.66%),雙眼6例(8.34%)；合計78只眼,右眼34只(43.59%),左眼44只(56.41%)；平均病程14.99±16.09月,最長8年,最短半個月；眼球突出55例(76.39%)、淚腺區(qū)發(fā)現(xiàn)腫物51例(70.83%)、眼瞼腫脹42例(58.33%)、疼痛21例(29.17%)、眼球運動受限38例(52.78%)、復(fù)視12例(16.67%)、視力下降19例(26.39%)、上瞼下垂16例(22.22%)。其中最常見的癥狀是眼球突出(76.39%)和淚腺區(qū)發(fā)現(xiàn)腫物(70.83%)；術(shù)后病理上皮性腫瘤共46例(63.89%),其中多形性腺瘤32例(44.44%),腺樣囊性癌11例(15.28%),腺癌3例(4.17%),非上皮性腫瘤(非霍奇金淋巴瘤)共14例(19.44%),類腫瘤(炎性假瘤)共12例(16.67%)。 B型超聲顯示淚腺多形性腺瘤病變形狀為圓形或類圓形,邊界清楚,內(nèi)回聲均勻；腺樣囊性癌病變形狀為扁平形,邊界清楚,內(nèi)回聲較少,聲衰減中等；腺癌為類圓形或不規(guī)則形占位病變,邊界不清楚,內(nèi)回聲中等,后界為弱回聲；非霍奇金淋巴瘤形狀不規(guī)則,邊界不清楚,內(nèi)回聲較低,聲衰減不顯著；炎性假瘤為不規(guī)則形占位病變,邊界清楚,但不整齊,低回聲,聲衰減顯著。CDI檢測淚腺多形性腺瘤內(nèi)部無血流信號或血流信號不豐富,而其他四種腫瘤內(nèi)部的血流信號豐富。測得多形性腺瘤的PSV11.06±5.13cm/S,EDV1.94±1.17cm/s,R10.49±0.21；腺樣囊性癌的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。將淚腺多形性腺瘤、腺樣囊性癌、非霍奇金淋巴瘤、炎性假瘤,這四種腫瘤的血流參數(shù)的PSV.EDV和RI值進行統(tǒng)計比較,發(fā)現(xiàn)有顯著性差異。 結(jié)論 淚腺腫瘤的彩色多普勒超聲征象與病理組織學(xué)特點密切相關(guān)。所以,利用彩色多普勒超聲可大致推斷淚腺腫瘤的病理組織學(xué)類型。 彩色多普勒超聲具有操作簡便、無創(chuàng)、重復(fù)性好、可動態(tài)下觀察顯示病變內(nèi)血流動力學(xué)資料的特點。可結(jié)合CT或MRI檢查對腫瘤進行定性診斷及鑒別診斷,對于淚腺腫瘤的診斷和治療具有指導(dǎo)意義。
[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 鹵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 鹵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 鹵5.13 cm / s EDV of pleomorphic adenoma was 1.94 鹵1.17 cm / s R10.49 鹵0.21; the PSV16.99 of adenoid cystic carcinoma was 5.75 鹵2.11 cm / s EDV 5.75 鹵2.11 cm / s EDV; the PSV17-34 鹵7.66 cm / s EDV of non-Hodgkin 's lymphoma was 5.47 鹵3.19 cm / r = 0.65 鹵0.11; the PSV18.66 鹵9.86 cm / s EDV of inflammatory pseudotumor was 5.09 鹵3.14 cm / r = 0.66 鹵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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R739.7;R445.1
本文編號：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 鹵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 鹵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 鹵5.13 cm / s EDV of pleomorphic adenoma was 1.94 鹵1.17 cm / s R10.49 鹵0.21; the PSV16.99 of adenoid cystic carcinoma was 5.75 鹵2.11 cm / s EDV 5.75 鹵2.11 cm / s EDV; the PSV17-34 鹵7.66 cm / s EDV of non-Hodgkin 's lymphoma was 5.47 鹵3.19 cm / r = 0.65 鹵0.11; the PSV18.66 鹵9.86 cm / s EDV of inflammatory pseudotumor was 5.09 鹵3.14 cm / r = 0.66 鹵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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R739.7;R445.1
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