眼眶静脉性血管瘤的MRI和CT表现  

Orbital Venous Hemangioma of the MRI and CT Manifestations

作　　者：关祥祯[1] 张雪宁[1] 杨静[1] 张文煜[1] 

机构地区：[1]天津医科大学第二医院放射科,300211

出　　处：《临床放射学杂志》2010年第7期888-891,共4页Journal of Clinical Radiology

摘　　要：目的分析眼眶静脉性血管瘤的MRI、CT表现,提高对眼眶静脉性血管瘤的影像学认识。资料与方法对49例经手术病理证实的眼眶静脉性血管瘤患者的MRI、CT资料进行回顾性分析。结果 49例中,位于眼眶前部1例,肌锥内间隙18例,肌锥外间隙3例,肌锥内外间隙同时受累27例。MRI扫描41例显示为边界清楚但不光滑,形状不规则的不均质肿块。6例肿物边界不清。与眼外肌相比,T1WI呈低或等信号,T2WI呈高信号,肿瘤内部或周边可见血管流空信号。T2WI脂肪抑制序列高信号不被抑制。46例眼球明显向前突出,7例显示眼球受压变形。29例显示病变沿眼球壁生长呈铸形。15例显示眶尖脂肪间隙消失。7例可见肿物向颅内蔓延。14例具有急性突眼病史者显示出血信号,7例可见液-液平面。CT扫描显示为不均匀的较高密度。5例显示单个或多个的静脉石。26例眶骨受压,眼眶扩大。10例显示眶上裂扩大。结论眼眶静脉性血管瘤在MRI、CT上分别具有其特征性征象。CT对展示骨性结构及钙化有优势,而MRI对肿瘤的内部形态及其与周围组织结构关系的进一步判断更具意义。MRI在定位和定性诊断上优于CT。Objective To analyse the CT and MR findings in 49 patients with orbital venous hemangioma,and raise awareness of its imaging features.Materials and Methods MRI、CT imaging of 49 patients with pathologically proved orbital venous hemangioma were retrospectively reviewed.Results Of 49 cases,1 case located in the anterior part of orbit,18 in the intraconal region,3 in the extraconal region,27 in both intraconal and extraconal region.MRI revealed irregular masses with clear but unsmooth margin in 41 cases.6 cases showed undemarcated.The lesions appeared hypointense or isointense on T2WI and hyperintense on T2WI with respect to muscles,with flow voids at the periphery of or within the tumor.The hyperintense signal can not be suppressed in fat-suppression T2WI sequence.There were ocular proptoses in 46 cases,deformation of the eyeball in 7 cases.Castling lesions could be seen in 29 cases in which the masses extended along the eyeballs.The fat in the orbital apex disappeared in 15 cases.The lesions spread into the cranial cavity in 7 cases.The hemorrhagic signal could be seen in 14 cases who had an acute exophthalmoses,and 7 of them showed fluid-fluid levels.On the CT scan,the lesions showed heterogeneous hyperdensity.There were single or multiple calcifications in 5 tumors,orbital bone depression and enlarged orbital cavity in 26 cases.Enlargement of the superior orbital fissure could be seen in 10 cases.Conclusion The orbital venous hemangiomas have characteristic signs respectively on MRI and CT.CT has advantage in displaying the orbital bone structures and the calcifications while MRI has more significance in detecting the internal morphology of tumor and its relationship with the surrounding tissues.MRI can be superior to CT in the localization and qualitative diagnosis of orbital venous hemangioma.

关 键 词：眼眶 静脉性血管瘤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R739.7[医药卫生—肿瘤]