常规超声和超声造影鉴别诊断眼眶淋巴瘤与炎性假瘤

目的 评价常规超声和超声造影（CEUS）鉴别诊断眼眶淋巴瘤与炎性假瘤的价值。方法 纳入18例单侧眼眶淋巴瘤（淋巴瘤组）和25例单侧炎性假瘤患者（炎性假瘤组）,观察2组病灶常规超声特征及CDFI血流信号特点,比较其CEUS动态血管模式曲线（DVPC）和时间-强度曲线（TIC）特点及相关定量参数差异。以病理结果为金标准,评价常规超声及CEUS鉴别诊断准确率。结果 常规超声诊断淋巴瘤、炎性假瘤准确率分别为38.89%（7/18）和36.00%（9/25）。淋巴瘤组DVPC多呈正负两相波形,TIC多呈快进快出模式;而炎性假瘤组DVPC多呈正向波形,TIC多呈快进慢出模式。CEUS诊断淋巴瘤和炎性假瘤准确率分别为55.56%（10/18）和52.00%（13/25）;淋巴瘤组峰值强度（IMAX）明显高于炎性假瘤组（P<0.05）,上升时间（RT）及平均通过时间（MTT）均明显低于炎性假瘤组（P均<0.05）。常规超声联合CEUS诊断淋巴瘤、炎性假瘤准确率分别为72.22%（13/18）和68.00%（17/25）。结论 常规超声联合CEUS鉴别诊断眼眶淋巴瘤和炎性假瘤具有重要临床价值。

Differential diagnosis of orbital lymphoma and inflammatory pseudotumor with conventional ultrasound and contrast enhanced ultrasound

Objective To observe the value of conventional ultrasound and contrast enhanced ultrasound (CEUS) in differential diagnosis of orbital lymphoma and inflammatory pseudotumor (IP). Methods A total of 18 patients with unilateral orbital lymphoma (lymphoma group) and 25 patients with unilateral IP (IP group) were enrolled. The lesions were firstly observed with conventional ultrasound and CDFI. Then the features of dynamic vascular pattern curve (DVPC) and time-intensity curve (TIC) were analyzed, and the relevant quantitative parameters of CEUS were compared between groups. Taken pathological results as the gold standards, the accuracies of conventional ultrasound and CEUS in differential diagnosis of orbital lymphoma and IP were evaluated. Results The accuracy of conventional ultrasound for diagnosing lymphoma and IP was 38.89% (7/18) and 36.00% (9/25), respectively. Most DVPCs of lymphoma present positive and negative waveforms, and most TIC were in "fast in and fast out" mode, while most DVPCs of IP presented positive waveform, and most TIC were in "fast in and slow out" mode. The accuracy of CEUS for diagnosing lymphoma and IP was 55.56% (10/18) and 52.00% (13/25), respectively. The maximum intensity (IMAX) in lymphoma group was significantly higher than that in IP group (P<0.05), whereas the rise time (RT) and mean transit time (MTT) in lymphoma group were significantly lower than those in IP group (all P<0.05). The accuracy of conventional ultrasound combined with CEUS for diagnosing lymphoma and IP was 72.22% (13/18) and 68.00% (17/25), respectively. Conclusion Conventional ultrasound combined with CEUS had important clinical value in differential diagnosis of orbital lymphoma and inflammatory pseudotumor.