眼眶海绵状血管瘤动态增强CT扫描的血液动力学特点分析  

Hemodynamic analysis of orbital cavernous hemangioma by dynamic enhanced CT scanning

作　　者：唐东润[1] 赵毅凯[1] 杨振海[1] 孙丰源[1] 赵红[1] 

机构地区：[1]天津市眼科医院天津医科大学眼科临床学院,眼眶病眼整形科,天津300020

出　　处：《中国实用眼科杂志》2009年第4期384-386,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的应用动态增强CT扫描对眼眶海绵状血管瘤进行血液动力学分析，确定肿瘤内的供血特点。方法为回顾性系列病例研究，于2006年4月至2007年12月期间病理组织学检查确诊海绵状血管瘤21例，除进行常规影像检查外，均进行动态增强CT扫描：男性11例，女性10例，右眼8例，左眼13例；年龄15—56岁，平均43．19岁。CT扫描采用双排螺旋CT扫描仪。使用德国MEDTRONinjecktron 82型高压注射器进行定量注射欧乃派克（Omnipaque），在注射后15-20s、60s、120s、180s和5min，10min进行扫描，观察肿瘤内部造影剂分布与扫描时间之间的关系，发现其规律性的变化。结果21例海绵状血管瘤动态增强CT扫描检查发现：在注射造影剂后15-20S肿瘤边缘处或内部出现点状高密度影，60s显示点状增强区域扩大，即灶状强化；2min时约有20％～30％区域被强化，到3min时达到30％～40％被强化，在5min时肿瘤内部达50％以上强化，在10min时肿瘤内部达70％～80％以上强化，有14例患者在20min时肿瘤内部呈均匀一致强化，CT值可达70～100Hu，甚至更高，以上增强特点即所谓“渐进性强化”。结论海绵状血管瘤在组织学和血流动力学上属于低流量动脉型的错构瘤。利用动态增强CT扫描对眼眶海绵状血管瘤进行血液动力学分析，可以反映出肿瘤内部的血液供应和分布情况，在不同的时期其表现不同。揭示肿瘤内部呈现“渐进性强化”的特点，可提高诊断的正确性，对手术治疗具有指导意义。Objective To analyze the hemodynamic characteristics of orbital cavernous hemangioma （OCH）by dynamic enhanced CT scanning and to reveal the hemodyanmic features of OCH.Method It was a retrospective case series study.21 cases with OCH presenting to Tianjin Eye Hospital from Apr,2006 to Dec, 2007 were analyzed retrospectively.They all were detected with dynamic enhanced CT scanning.All the 21 cases were diagnostic determined by histopathology after operation.We took the plain CT scanning to reveal the position, shape, density of the tumor and the relationship between the tumor and the surrounding tissues and then we took the dynamic enhanced scanning.Among the 21 cases, 11 of which were male, 10 were female, 8 were lesioned in right eye and 13 were lesioned in left eye.Their age ranged from 15 to 56 years,averaged 43.19 years old.We used the high pressure syringe, Germany MEDTRON Injecktron 82 type, to i.v.inject 75-80 ml Omnipaque with the speed of 2.5ml/s.At 15-20s,60s, 120s, 180s,5min and 10min after the injection,we used GE Pro Speed Ⅱ double-row coiling CT scanner to observe the relationship between the distribution of the constrast agent in the tumor and the scanning time and to discover its regularity.Results The tumor showed ＂gradually enhanced＂ when it was enhanced.After injected the constrast agent the patients were scaned immediately.The tumors were firstly inferior or marginally enhanced with the features of punctiform, focal, nodous or plaque-like enhance.The enhanced extent dilated but the CT values lowered gradually.When they had a lot of blood vessels and less fibrous tissue on pathologic film preparation, most of their CT values advanced obviously and the rate of the ＂gradual enhance＂ were fast.Conclusion Cavernous hemangiomas are considered to be a vascular hamartomas with low-flow vessels in the histopathology and haemodynamics.The analysis of the hemodynamic characteristics of OCH by dynamic enhanced CT scanning demonstrated its features on blood supply and distribution, and ＂gra

关 键 词：海绵状血管瘤 眼眶 CT扫描 动态增强扫描 渐进性强化 

分 类 号：R734.2[医药卫生—肿瘤] R739.72[医药卫生—临床医学]