Department of Ophthalmology, Orbital Ophthalmic Plastic and Lacrimal Surgery Institute, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel.
School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Indian J Ophthalmol. 2024 Oct 1;72(10):1448-1452. doi: 10.4103/IJO.IJO_2109_23. Epub 2024 Sep 27.
To determine the role of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) in differentiating the inflammatory process and malignant lymphoma of the lacrimal gland.
A retrospective analysis of all subjects who underwent lacrimal gland biopsy and magnetic resonance (MR) imaging with DWI sequences during a 10-year period at the Sheba Medical Center, Israel. The lacrimal glands' ADC values were documented bilaterally by blinded observers and correlated with the final histology verified diagnoses.
Twenty-eight patients were included, with 19 females (68%) with a mean ± SD age of 48.1 ± 25.7 years. The right orbit was involved in 14 cases (50%) and the left in 13 (46%); one patient (4%) had bilateral involvement. Seventeen cases (61%) had a final diagnosis of idiopathic inflammation or dacryoadenitis, and six cases (21%) were diagnosed with lymphoma. Additional diagnoses included pleomorphic adenoma in 3 (11%), adenoid cystic carcinoma, and solitary fibrous tumor. Lower mean ADC values were observed in the lymphoma versus inflammatory group (1.03 × 10-3 Vs. 1.45 × 10-3, P = 0.02).
Restricted diffusion on MR imaging can serve as a diagnostic tool in the differentiation between inflammatory processes of the lacrimal gland and lymphoma.
确定扩散加权成像（DWI）及其表观扩散系数（ADC）在鉴别泪腺炎症过程和恶性淋巴瘤中的作用。
对以色列谢巴医疗中心 10 年间进行泪腺活检和磁共振（MR）成像并带有 DWI 序列的所有患者进行回顾性分析。由盲法观察者记录双侧泪腺 ADC 值，并与最终经组织学证实的诊断相关联。
共纳入 28 例患者，其中 19 例为女性（68%），平均年龄为 48.1 ± 25.7 岁。14 例（50%）右侧眼眶受累，13 例（46%）左侧眼眶受累，1 例（4%）双侧受累。17 例（61%）的最终诊断为特发性炎症或泪腺炎，6 例（21%）诊断为淋巴瘤。其他诊断包括多形性腺瘤 3 例（11%）、腺样囊性癌和孤立性纤维瘤。与炎症组相比，淋巴瘤组的平均 ADC 值较低（1.03×10-3 vs. 1.45×10-3，P=0.02）。
MR 成像上的弥散受限可作为鉴别泪腺炎症过程和淋巴瘤的一种诊断工具。
