眼眶海绵状血管瘤与神经鞘瘤的CT鉴别诊断  

Differentiation of cavernous hemangioma from schwannoma of the orbit with CT

作　　者：赵毅凯[1] 杨振海[1] 尹智[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影像科,天津300020

出　　处：《中国实用眼科杂志》2009年第10期1157-1159,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 评价螺旋CT多期增强检查对于眼眶海绵状血管瘤和神经鞘瘤的鉴别诊断价值.方法 38例眼眶海绵状血管瘤和16例神经鞘瘤,均为单眼发病,所有患者均行CT平扫,其中23例海绵状血管瘤和10例神经鞘瘤行多期增强CT检查.观察肿瘤的增强方式.结果 所有海绵状血管瘤呈＂渐进性强化＂,增强早期,56.5%（13/23）海绵状血管瘤增强起自一点,43.5%（10/23）起自多点,73.9%（17/23）增强点位于边缘,26.1%（6/23）位于中央,随时间延迟强化逐步向全肿瘤扩展;增强早期4例神经鞘瘤为均匀强化,5例为伴有小片状低密度区的不均匀强化,1例为囊性变不强化,囊壁强化,随时间延迟强化程度无明显无变化.两种肿瘤的强化方式差异有统计学意义（P＜0.01）.结论 螺旋CT多期增强检查可有助于鉴别眼眶海绵状血管瘤和神经鞘瘤.Objective To evaluate the value of multi-phase contrast-enhanced CT in differentiating cavernous hemangioma from schwannoma of the orbit.Methods Thirty-eight cavernous hemangiomas and 16 schwannomas were involved in unilateal eye and were performed by non-enhancement CT.After injection of contrast medium, the multi-phase enhanced scan was performed so as to observe dynamic changes of 23 cavernous hemangiomas and 10 schwannomas.Results All cavernous hemangiomas demonstrated ＂progressive enhancement＂.In early enhanced phase, 13 cavernous hemangiomas started enhancement from one point and 10 cavernous hemangiomas started enhancement from several points, enhancement point was located in the edge of tumor in 17 and which in the center in 6 cavernous hemangiomas, then they expanded to whole tumor in delayed phase.After injection of intravenous contrast medium, 4 schwannomas showed homogeneous marked contrast enhancement and 5 schwannomas demonstrated heterogenous enhancement area with small patches of hypodensity areas, one schwannoma demonstrated non-enhancement.The difference of two types of tumors in the contrast-enhancement pattern features was statistically significant （P〈0.01）.Conclusions Cavernous hemangioma and schwannoma of the orbit could be differentiated by the contrast-enhancement pattern on multi-phase contrast-enhanced CT.

关 键 词：多期增强检查 眼眶 海绵状血管瘤 神经鞘瘤 体层摄影术 X线计算机 

分 类 号：R739.72[医药卫生—肿瘤] R814[医药卫生—临床医学]