眶部肌锥外间隙疾病的HR-MRI表现  

The Appearances of Extraconal Orbital Diseases on High-resolution MR Using Surface Coils

作　　者：周全[1] 刘斯润[1] 黄力[1] Arne-Jrn Lemke 

机构地区：[1]暨南大学附属第一医院医学影像中心 [2]Department of Radiology,Virchow-Hospital,Charité,Humboldt-University,Berlin13353,Germany

出　　处：《实用放射学杂志》2004年第12期1063-1068,共6页Journal of Practical Radiology

基　　金：教育部留学回国人员科研启动基金资助项目 (教外司留[2 0 0 4 ] 1 76号 )

摘　　要：目的　总结眶部肌锥外间隙疾病的HR -MRI影像表现 ,以提高对其进行鉴别诊断的能力。方法　对诊断明确的 44例累及眶部肌锥外间隙病变的位置、形态、大小、边缘、范围、邻近结构及磁共振信号的变化情况进行回顾性分析。磁共振扫描采用 1.5TGESigna及SiemensMagnetomSp63磁共振扫描机 ,用眶部表面线圈 ,SE系列常规轴位、冠状位及矢状位扫描 ,2 1例行脂肪抑制扫描、41例行增强扫描。结果　眶部淋巴瘤、血管瘤、炎性假瘤、横纹肌肉瘤及转移瘤等占此区病变总数的 70 %。 3例血管瘤表现为圆形、边缘清楚的肿块 ,眶部淋巴瘤多为边界不清、不规则形的大病灶 ,转移瘤及横纹肌肉瘤多为圆形、边界不清的病灶。淋巴瘤的占位推移效应不明显而更多是对邻近结构的浸润与侵犯。淋巴管瘤MRI信号表现为特征性的无强化的短T1长T2 信号 ,黑色素转移瘤具有特征性的短T1短T2 信号 ,3例血管瘤的强化明显而不同于其他肿瘤。横纹肌肉瘤发病的平均年龄为 7岁 ,5 0 %转移瘤具有明确的先前原发肿瘤病史 ,3例炎性假瘤均对激素治疗敏感。结论　病变位置、MRI信号及形态学特征、临床病史及占位效应对眶部疾病的鉴别诊断有重要作用。Objective To summarize the important HR-MRI manifestations of orbital disease in extraconal compartment.Methods Forty-four patients with extraconal orbital disease identified pathologically were analysed retrospectively. MRI of the orbit at 1.5 Tesla was performed with surface coil, thin slice, suitable bandwidth, small field of view (FOV) and large matrix. The analyzed criteria of imaging appearance were: location, shape,size, margins, extent, adjacent structures, and signal intensity.Results Lymphoma, hemangioma, rhabdomyosarcoma, metastasis, pseudotumor, and phlegmon accounted for 70% of all extraconal orbital diseases. Three cases of haemangioma had round shape and clear margin; most lymphoma had irregular shape, unclear margin and big volume; while most rhabdomyosarcoma and metastasis had round shape and unclear margin. The effect of space-occupying of lymphoma was not obvious. One case of lymphangioma had high signal intensity on both T 1- and T 2-weighted images without enhancement. Melanomametastasis appeared hyperintense on T 1- weighted and hypointense on T 2-weighted images. The contrast-enhancement of haemangioma was much more prominent than others. There were characteristic of rhabdomyosarcoma, metastasis, pseudotumor, and phlegmon about their age,clinical history and examination. Conclusion Location criteria, morphological changes, MRI signal intensity, clinical history and the effect of space-occupying are very useful in the differential diagnosis of the orbital disease.

关 键 词：眶部肿瘤 肌锥外间隙 磁共振成像 

分 类 号：R739.72[医药卫生—肿瘤] R445.2[医药卫生—临床医学]