视神经原发性肿瘤的影像学表现  

Image Expression of Primary Optic Nerve Tumor

作　　者：白玫[1] 韩悦[1] 丁莹[2] 

机构地区：[1]天津医科大学第二医院放射科,300211 [2]天津医科大学第二医院眼科,300211

出　　处：《天津医药》2006年第2期91-93,共3页Tianjin Medical Journal

摘　　要：目的:探讨视神经原发性肿瘤的CT和MRI表现及其临床价值。方法:回顾性分析经手术病理证实的20例视神经肿瘤患者的CT、MRI表现,并与手术结果相对照。结果:视神经胶质瘤12例,影像图均表现为视神经梭形增粗,边缘光滑清楚。CT表现为软组织密度,有强化。MRI上病变于T1WI呈低信号,T2WI呈较高信号,有强化。视神经鞘脑膜瘤8例,影像图表现为视神经一致性增粗(2例)、梭形肿块(2例)、不规则偏心性肿块(4例),病灶边缘清楚但欠光滑。CT上表现为软组织密度,2例伴钙化,有强化。MRI上T1WI呈中等或稍低信号,T2WI呈中等或略高(或低)信号,强化明显。经手术证实病变限于眶内者9例(术前CT显示为12例,MRI显示为9例);累及视神经管内段6例(术前CT显示为3例,MRI显示为6例),累及颅内5例(术前CT、MRI均显示为5例)。结论:视神经胶质瘤与视神经脑膜瘤均有典型的影像学表现,MRI较CT更利于显示肿瘤向视神经管内及颅内侵犯的范围与程度。Objective：To evaluate CT and MRI findings of the primary tumors of optic nerve and their clinical value. Methods： CT and MRI manifestations were reviewed and analyzed on 20 cases with the tumors of optic nerve, which were confirmed by pathology and clinical follow-ups. Results： Glioma of optic nerve was found in 12 cases, in all of wbich the fusiform optic nerve was enlarged and the edges became smooth and clear. CT indicated that the density of soft tissues was intensified. Meningioma of optic nerve sheath was found in 8 cases, of wbich consistency enlargement of optic nerve was seen in 2 cases, fusiform mass in 2 cases, and irregular decentered mass in 4 cases, in all of which focal edges were clear but not smooth. In terms of the density of soft tissues was indicated by CT. Two cases showed calcification and clear intensification. Meningioma showed hypoor isointense mass on T1-weighted images, and iso-or hyperintense （or isointense） mass on T2 images, with clear intensification. Operation demonstrated that pathological changes were limited in orbit in 9 cases （before operation, CT and MRI indicated 12 and 9 cases respectively）; 6 cases showed diffuse enlargement of optic canal （before operation, CT indicated 3 cases, and MRI indicated 6 cases）, and 5 cases displayed diffuse intracranial enlargement （before operation, both CT and MRI indicated 5 cases）. Conclusion： Both glioma of optic nerve and meningioma of optic nerve had their own typical image expressions. MRI, compared with CT, was more advantageous to indicate tumors as well as the invasion scope and extent into the optic canal and intracranial part.

关 键 词：视神经疾病 肿瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.7[医药卫生—肿瘤] R734.2[医药卫生—临床医学]