眼眶分区及CT、MRI征象在眼眶占位性病变中的诊断价值  

Value of orbital division and imaging features in the diagnosis of orbital space-occupying lesions

作　　者：董妍[1] 曾自三[1] 李涛[1] 黄丽轩 

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2017年第7期992-995,共4页Journal of Practical Radiology

基　　金：广西自然科学基金项目（81660287）;广西教育厅重点项目（2D2014032）.

摘　　要：目的 探讨眼眶分区及CT、MRI征象在鉴别眼眶良、恶性占位性病变的诊断价值.方法 收集201例经病理证实的眼眶占位性病变临床及CT、MRI资料,按4分区法统计分析病变在眼眶各区的分布情况及病变部位、形态、边界、与周围结构关系、MRI信号、CT密度、钙化、眶壁骨质改变等指标在鉴别眼眶良、恶性占位的诊断价值.结果 （1）病变分布：①眼眶良、恶性占位性病变总体在各区的分布差异有统计学意义（χ2总=48.93,P=0.000）.病变仅位于骨膜外区18例、神经鞘区4例、肌锥内区39例均为良性.肌锥外区病变103例,良性（64%,66/103）多于恶性（36%,37/103）.②眼眶良、恶性占位性病变在单区及混合区的分布差异有统计学意义（χ2=25.559,P=0.000）.164例单区病变,良性（77%,127/164）多于恶性（23%,37/164）;37例混合区病变,恶性（65%,24/37）多于良性（35%,13/37）.（2）CT、MRI征象：201例病变,140例良性,61例恶性,其中（良性/恶性）：形态规则（93/10）,边界清楚（108/24）,包绕眼球（24/39）,骨质破坏（4/11）.病变形态、边界、包绕眼球、骨质破坏在眼眶良、恶性病变之间有差异.钙化、T1WI/T2WI信号、眼球变形移位及是否单双侧发病在眼眶良、恶性病变中无差异.结论 眼眶占位性病变在眼眶各区的分布及其CT、MRI征象有一定规律, 根据眼眶分区及征象特点有助于诊断.Objective To investigate the value of the imaging division and features of CT and MRI in the differential diagnosis of benign and malignant space-occupying lesions.Methods A retrospective analysis of the clinical and imaging data of 201 patients with orbital space-occupying lesions confirmed by pathology was conducted.Four sector method was used to analyze the distribution of the lesions.The shape,border and relationship with surrounding tissues,MRI signal,CT density,and calcification of the orbital wall were also analyzed.Results There was statistical difference in the distribution of lesions in each of the 4-sector between orbital benign lesions and malignant tumors（χ2总=48.93,P=0.000）.Lesions located in separate orbital zone including extra-periosteum compartment （18 cases）,optic nerve compartment （4 cases）,intraconal compartment（39 cases） were benign.Benign lesions （64%, 66/103） were more than malignant lesions （36%,37/103） in 103 lesions located in extraconal compartment.Additionally,there was significance in the distribution in separate and mixed zones between benign and malignant lesions（χ2=25.559,P=0.000）.Benign lesions （77%,127/164） were more than malicious lesions（23%,37/164） in 164 cases in separate zone.Malignant lesions （65%,24/37） were more than benignant lesions （35%,13/37） in the 37 lesions located in mixed zone.Signs of CT and MRI：the benign and malignant lesions were 140 and 61,respectively.The features of those lesions are as follows（ratio=benign lesions/ malignant lesions）：regular morphology（ratio=93/10）,clear boundary（ratio=108/24）,eyeball-surrounded （ratio=24/39）,bone destruction （ratio=4/11）.Features of lesions including shape,border,eyeball-surrounded, bone destruction had significant difference between benign and malignant lesions,whereas no differences was observed in calcification,signal on T1WI or T2WI,displacement of the eyeball and the occurrence of single or bilateral lesions.Conclusion The characteristic distrib

关 键 词：眼眶分区 占位性病变 计算机体层成像 磁共振成像 

分 类 号：R777.5[医药卫生—眼科] R814.42[医药卫生—临床医学]