眼眶血管外皮瘤影像分析  

Imaging Analysis of the Orbital Hemangiopericytoma

作　　者：钱雯[1] 唐作华[1] 包兵[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院放射科

出　　处：《中国医学计算机成像杂志》2013年第6期485-488,共4页Chinese Computed Medical Imaging

摘　　要：目的:分析眼眶血管外皮瘤(HPC)的CT和MRI影像表现和特征,以期提高该病的影像诊断和鉴别诊断。方法:9例HPC(其中4例为恶性)均行CT检查,其中2例行MRI T1WI、T2WI和T1WI增强检查,1例行CT动态增强延迟扫描。结果:①部位:6例发生于球后(4例位于肌锥内间隙、1例位于肌锥外间隙、1例位于肌锥内和外间隙),3例位于眼眶浅部。②形态:7例呈圆形或不规则类圆形,2例呈梭形;边缘粗糙3例,呈模糊或浸润状3例,分叶状2例,呈光滑圆形仅1例;恶性HPC中2例呈多发性(2个结节)。③密度和信号:7例肿瘤密度均匀或较均匀,2例恶性肿瘤内见多发囊性灶;MRI T1WI和T2WI均呈中等信号,与脑实质相仿;所有病例肿瘤实质区均强化显著,1例CT动态增强延迟扫描表现为速升速降。④骨质:2例眶骨轻度受压,1例恶性HPC伴眶骨破坏。结论:HPC较多见于球后、眼眶鼻侧或上部,大多数呈分叶状、边缘粗糙或浸润状,增强很显著,恶性HPC较易呈多发性及发生囊性或坏死改变,综合分析其影像表现有助于诊断和鉴别诊断。Purpose： To improve the diagnosis and differential diagnosis of orbital hemangiopericytoma （HPC） by analyzing the CT and MRI manifestations and features. Methods： Nine cases of orbital HPC （four of them were malignant） were undergone CT scans, among them two were also performed MRI examination and one with dynamic contrast CT study. Results： （1） Location： Six tumors located in retrobulbar region （four in intraconal region, one in extraconal region and one in both） and other three in the superficial part. （2） Shape： Seven tumors were with rounded or irregular-rounded shape and two with fusiform appearance; Three were with rough margin, three with infiltrating appearance, two with multilobular shape and only one with smooth rounded margin; Two malignant HPC had a multi-nodular feature. （3） Density and intensity： Seven tumors showed homogeneous density and two malignant ones presented some necrotic or cystic changes in the tumors. The MRI intensity was moderate in both TIWI and T2WI images as that of the brain. All cases showed marked enhancement. One case of dynamic contrast CT study showed ＂rapid in - rapid out＂ pattern. （4） Bony changes： Two cases showed slightly bony compression and one malignant tumor showed with bony destruction. Conclusion： Orbital HPC are more likely to locate in the retrobulbar, superior or interior part of the orbit. Most tumors have multi-lobular, irregular or infiltrating appearance with marked enhancement. The malignant cases are more likely to have multi-nodular features and necrotic or cystic changes in the tumors. Familiar with all of these imaging features is helpful for the differential diagnosis.

关 键 词：眼眶 血管外皮瘤 影像诊断 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]