目的 分析原发性泪囊肿瘤患者 CT、MRI影像学表现及病理特点。方法 回 顾性分析2008年2月-2018年8月我院诊治 的12例原发性泪囊肿瘤患者的临床资料， 病例患者均行CT、MRI影像学检查和病理 学检查，分析12例原发性泪囊肿瘤患者 CT、MRI影像学表现及病理特点。结果 (1)CT：肿瘤形态规则者8例；3例出现鼻 泪管内蔓延；3例表现为泪囊区梭形软组 织密度肿块，密度不均匀，与周围结构分 界不清楚，往下将侵犯鼻泪管，管壁骨质 破坏，管腔扩大，增强CT扫描后可见不均 匀中度强化；2例泪囊混合瘤，CT影像学 表现为泪囊区椭圆形软组织密度肿块，密 度不均匀，边缘光滑；(2)MRI：肿瘤形态 规则者7例；8例出现鼻泪管内蔓延；以脑 皮质信号为参照，6例患者MRI影像学表现 呈等T1、等T2信号，3例呈等T1、稍短T2信 号，1例呈稍短T1、等T2信号，2例呈混杂 T1、短T2信号；6例MRI扫描检查提示T2WI 上合并有囊变，1例不仅出现囊变且有出 血现象；10例恶性肿瘤患者在DWI上，平 均ADC值为(0.90±0.16)×10-3mm2 /s。(3) 病理结果：12例患者，共有10例恶性肿 瘤，包含鳞状细胞癌4例、移行细胞癌3 例、黑色素瘤2例、交界性肿瘤1例；良性 肿瘤2例，均为内翻性乳头状瘤。结论 原 发性泪囊肿瘤患者有典型CT、MRI影像学 表现和病理特点，三者联合检查可明确诊 断原发性泪囊肿瘤的位置、形态以及良恶 性等。

Objective To analyze the CT, MRI imaging manifestation and pathological features of patients with primary tumor of dacrycyst. Methods The clinical data of 12 patients with primary tumor of dacrycyst diagnosed in the hospital from February 2008 to August 1818 were retrospectively analyzed. All patients were given CT, MRI imaging and pathological examination. CT, MRI imaging manifestation and pathological features of 12 patients with tumor of dacrycyst were analyzed. Results (1) CT: There were 8 cases of regular tumor morphology, 3 cases of nasolacrimal duct spreading, 3 cases of fusiform soft tissue density lump in the lacrimal sac area, uneven density and unclear boundary with surrounding structure, it would invade the nasolacrimal duct, wall bone was destroyed, lumen expanded, there was inhomogeneous moderate enhancement after enhanced CT scan. There were 2 cases of lacrimal sac mixed tumor, CT imaging manifested elliptical soft tissue density lump in the lacrimal sac area, uneven density and edge smoothness. (2) MRI: There were 7 cases of regular tumor morphology, 8 cases of nasolacrimal duct spreading. Taking cerebral cortex signal as reference, there were 6 cases of equal T1, equal T2 signal by MRI imaging, 3 cases of equal T1 and slightly short T2 signal, 1 case of slightly shorter T1, equal T2 signal, 2 cases of mixed T1, short T2 signal. There were 6 cases of T2WI combined with cystic change noted by MRI scan, 1 case of cystic change and bleeding phenomenon, 10 patients with malignant tumors on the DWI, the mean ADC value was (0.90±0.16)×10-3mm2 /s. (3) Pathological results: There were 10 malignant tumors in 12 patients, including 4 cases of squamous cell carcinoma, 3 cases of transitional cell carcinoma, 2 cases of melanoma, 1 case of borderline tumor and 2 cases of benign tumors, all of them were inverting papilloma. Conclusion Patients with primary tumor of dacrycyst have typical CT, MRI imaging manifestation and pathological features. The combined examination of the three methods can demonstrated the location, morphology and benign and malignant aspects of primary tumor of dacrycyst clearly.