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目的探讨泪腺腺样囊腺癌(adenoid cystic carcinoma,ACC)的MRI特征,为临床早期诊断提供依据。设计回顾性病例系列。研究对象北京同仁医院经手术证实ACC患者26例,术前均行MRI扫描。方法所有ACC患者常规MRI扫描;同时对动态增强磁共振成像(DCE-MRI)及磁共振扩散加权成像(DWI)图像进行后处理获得相应量化指标。主要指标ACC动态增强的峰值强化指数(CIpeak)、峰值强化时间(Tpeak)、最大强化指数(CImax)、强化指数曲线(I型为持续上升型,II型为平台型,III型为流出型)、肿瘤平均表观扩散系数(ADC)值。结果 26例均起自泪腺眶部,20例形态不规则,14例边界不清,12例边界清晰,6例累及颅内,9例出现骨质破坏。T1WI呈等或略低信号,其中3例内部出现高信号区;T2WI呈等或稍高信号为主,增强后仅1例强化均匀,25例呈不均匀强化,其中16例伴有内部囊变、坏死区。泪腺ACC峰值强化指数(CIpeak)为0.9±0.41,峰值强化时间(Tpeak)为(109.3±58.5)s,最大强化指数(CImax)为0.95±0.45。22例时间强化指数曲线中2例为I型,14例为II型,6例为III型。平均ADC值为(1.25±0.30×10-3)mm2·s-1。结论 MRI可以清晰显示泪腺ACC的部位、形态、范围、边界及骨质侵犯,DCE-MRI及DWI为肿瘤的诊断及鉴别诊断提供辅助量化特征。
Objective To investigate the MRI features of adenoid cystic carcinoma (ACC) in lacrimal gland and provide the basis for early clinical diagnosis. Design retrospective case series. Subjects Beijing Tongren Hospital confirmed by surgery in 26 patients with ACC, preoperative MRI scan. Methods All patients with ACC underwent routine MRI scans. Meanwhile, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) images were post-processed to obtain corresponding quantitative indicators. The main indicators ACC dynamic enhanced peak intensification index (CIpeak), peak enhancement time (Tpeak), the maximum enhancement index (CImax), enhanced index curve (type I for the rising type, type II for the platform type, type III for the outflow type) , Tumor average apparent diffusion coefficient (ADC) values. Results All 26 cases started from the orbital part of lacrimal gland, 20 cases were irregular in shape, the border was unclear in 14 cases, the border was clear in 12 cases, intracranial in 6 cases and intraosseous in 9 cases. T1WI was equal or slightly lower signal, including 3 cases of high signal within the area; T2WI was equal or slightly higher signal, enhanced only 1 case of enhanced uniform, 25 cases were unevenly enhanced, of which 16 cases with internal cystic degeneration , Necrosis area. The laparoscopic ACC peak enhancement index (CIpeak) was 0.9 ± 0.41, the peak enhancement time (Tpeak) was (109.3 ± 58.5) s, the maximum enhancement index (CImax) was 0.95 ± 0.45.2 Two cases of time enhancement index curve were type I 14 were type II and 6 were type III. The average ADC value was (1.25 ± 0.30 × 10-3) mm2 · s-1. Conclusion MRI can clearly show the location, shape, extent, border and bone invasion of ACC in lacrimal gland. DCE-MRI and DWI can provide auxiliary quantitative features for the diagnosis and differential diagnosis of tumors.