视神经鞘脑膜瘤50例临床分析  

Clinical analysis of optic nerve sheath meningiomas in 50 cases

作　　者：苟文 肖利华[2] 李月月[2] 杨新吉[2] 黑砚[2] 朱慧[2] 

机构地区：[1]江苏省宜兴市武警医院眼科,214206 [2]武警总医院眼眶病研究所,北京市100039

出　　处：《眼科新进展》2009年第4期284-287,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨视神经鞘脑膜瘤的临床表现、影像学特征及治疗原则,以求更好的治疗效果。方法回顾性分析1999年6月至2006年5月诊治的视神经鞘脑膜瘤患者50例(53眼),对全部病例的临床资料、标准化A/B超、彩色多普勒成像、CT和MRI图像、治疗方案和手术方式进行分析。结果视神经鞘脑膜瘤多发生于中年女性。主要表现为视力下降或丧失、眼球突出,眼底检查可见视盘慢性水肿性萎缩和视睫状静脉。标准化A/B超和CT有特征性表现,可以显示视神经增粗、眶内软组织肿块,MRI对于观察视神经管内及颅内蔓延情况,效果更好。治疗原则包括观察、放射治疗、手术切除或与放射治疗结合等。结论视神经鞘脑膜瘤是一种较常见的眼眶肿瘤,早期正确诊断较难,影像学检查有助于诊断和鉴别诊断。确诊后可根据病变位置、大小、范围、发展趋势和患者具体情况予以个体化治疗。Objective To investigate the clinical manifestation, imaging characters and therapeutic principle of optic nerve sheath meningiomas to get a better clinical effect. Methods Fifty cases（53 eyes） with optic nerve sheath meningioma from June 1999 to May 2006 were studied retrospectively. Clinical data of all cases, standard A/B ultrasonography scanning, color doppler flow imaging, imaging of CT and MRI, treatments and surgical procedures were reviewed. Results Optic nerve sheath meningioma were seen mostly in middie-aged females. Patients typically presented with visual loss, exophthalmos, optic chronic edematous atrophy and optic ciliary veins with examination of fundus. There were significant appearances with standard A/B ultrasonography and CT, which indicated that optic nerve became thicker and lump was found at orbital soft tissue. MRI had a better effect on observing extension in optic canal and at intracalvarium. The therapeutic principles inchided observation, radiotherapy, exalresis or it combined with radiotherapy. Conclusion Optic nerve sheath meningiomas is a common tumor of orbit, and difficult to diagnosis correctly at early stage, but can be differentiated and diagnosed with imaging. Pathological location, size, scope, aggravation and specific situation of patients should be considered to do individualized treatment after fmal diagnosis.

关 键 词：视神经鞘脑膜瘤 计算机体层摄影术 磁共振成像 放射治疗 

分 类 号：R774.6[医药卫生—眼科]