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目的:探讨眼睑恶性肿瘤影像表现及诊断价值。方法:回顾性分析经手术和病理证实的眼睑恶性肿瘤21例,术前17例行MSCT扫描,2例行CT及MRI检查,2例仅MRI检查平扫及增强。结果:眼睑恶性肿瘤21例,男12例,女9例。年龄6~86岁。病程1月~10年。均为单眼发病,发生在下睑者11例(52.4%),上睑4例(19.1%),内眦6例(28.5%),其中基底细胞癌13例,皮质腺癌、鳞状细胞癌、黑色素瘤、非何杰金氏淋巴瘤(NHL)各2例。CT及MRI表现:11例基底细胞癌表现为眼睑小结节,结节中央见溃疡;2例表现为不规则深溃疡,其中1例深达骨质。皮质腺癌1例见点状钙化,2例鳞癌为下睑结节状稍高密度影,中央浅凹陷,界清。MRI呈等T1等T2信号,STIR为高信号,增强轻度强化。黑色素瘤CT表现稍高密度结节,界限清,表面不光整,可见凹陷区。NHL1例为内眦部结节,1例为上睑皮下肿块,环绕眼球,界限不清,内密度均匀。结论:眼睑恶性肿瘤好发于中老年人,好发部位为下睑,其次为内眦和上睑。大部分恶性肿瘤影像表现为结节样肿物,表面凹凸不平,基底细胞癌易形成溃疡。鉴别诊断缺乏特征性,确诊有赖于病理学检查。MSCT及MRI检查可显示眼睑恶性肿瘤的浸润范围,为临床制定手术方案提供指导。
Objective: To investigate the imaging manifestations and diagnostic value of malignant eyelid tumors. Methods: Twenty-one cases of malignant eyelid tumors confirmed by surgery and pathology were retrospectively analyzed. MSCT scanning was performed in 17 cases before operation, CT and MRI in 2 cases, and MRI scan in 2 cases. Results: Eyelid malignant tumors in 21 cases, 12 males and 9 females. Age 6 to 86 years old. Duration of 1 months to 10 years. (52.4%) in the lower eyelid, 4 cases (19.1%) in the upper eyelid, and 6 cases (28.5%) in the levator ani. Among them, 13 were basal cell carcinoma, corticobasal carcinoma, squamous cell carcinoma, Melanoma, non-Hodgkin’s lymphoma (NHL) in 2 cases. CT and MRI manifestations: 11 cases of basal cell carcinoma showed small eyelid nodules, ulcers in the central nodules; 2 cases showed irregular deep ulcers, of which 1 case of deep bone. 1 case of cortical adenocarcinoma see point calcification, 2 cases of squamous cell carcinoma of the lower eyelid nodular slightly high density, central shallow depression, boundary clearance. MRI showed equal T2 and other T2 signals, STIR is a high signal, enhanced mild enhancement. Melanoma CT showed a slightly higher density of nodules, clear boundary, the surface is not only the whole area can be seen depression. NHL 1 cases of the Ministry of internal nodules, 1 case of the upper eyelid subcutaneous mass, around the eye, the boundaries are unclear, the density is uniform. Conclusion: Eyelid malignancies occur in middle-aged and elderly patients. The predilection sites are lower eyelid, followed by the infraorbital and upper eyelid. Most of the malignant tumor image showed nodular-like tumor, the surface uneven, basal cell carcinoma is easy to form ulcers. Differential diagnosis of the lack of characteristic diagnosis depends on the pathological examination. MSCT and MRI examination can show the extent of infiltration of malignant tumors of the eyelids, to provide guidance for the development of clinical options.