蝶骨嵴脑膜瘤在眼部临床表现及MRI成像特征  

Clinical manifestations and MRI imaging features of sphenoid ridge meningiomas in the eye

作　　者：赵立宇[1] 韦超兵[1] 赵海峰[1] 江晓春[2] 吴昌凡[1] Zhao Liyu Wei Chaobing Zhao Haifeng Jiang Xiaochun Wu Changfan(Wannan Medical College Yijishan Hospital, Wuhu 241001, China)

机构地区：[1]皖南医学院弋矶山医院眼科,安徽省芜湖市241001 [2]皖南医学院弋矶山医院神经外科,安徽省芜湖市241001

出　　处：《中国实用眼科杂志》2017年第7期734-737,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨蝶骨嵴脑膜瘤在眼部的临床表现、MRI成像特征及术后视功能预后。方法回顾性分析11例经手术后诊断明确的蝶骨嵴脑膜瘤患者的眼部临床表现，病灶在MRI中的形态、大小、及与临近组织的关系，以及术后的视力、眼球突出及视野的恢复情况。结果11例蝶骨嵴脑膜瘤患者，临床表现中患侧视力下降9例，眼球突出7例，视野缺损6例；MRI示7例为眶颅沟通肿瘤，4例为颅内单发肿瘤，肿瘤最大径为2．3—8．2cm；T1WI均呈中等及偏低信号，T2WI均呈中等及偏高信号，所有肿瘤均呈均匀强化；肿瘤与周边脑组织边界清晰者9例，边界模糊者2例；侵犯视神经引起视神经密度、位置改变者7例。手术入路包括颅眶颧入路和翼点入路，术中尽量切除肿物，术后随访中，视力损伤者术后视力提高2例；眼球突出者中术后有3例恢复正常，此外4例眼球突出度减少；视野缺损者术后视野好转者3例。结论蝶骨嵴脑膜瘤可发生于各年龄段的人群，眼科症状以视力下降、眼球突出、视野缺损为主，MRI成像中T1WI多呈中等及偏低信号、T2WI呈中等及偏高信号，均匀强化，瘤体内密度较一致。术后视力恢复情况依赖于术前残存视力，视力越好预后越佳，眼球突出及视野缺损预后较好。Objective To investigate the clinical manifestation, MRI imaging features and visual function prognosis of sphenoid wing meningioma in the eyes. Methods A retrospective analyzed of 11 patients with sphenoid wing meningioma diagnosed by surgery, the clinical manifestations, the shape and size of lesions in MRI, the relationship with adjacent tissues, as well as postoperative vi- sion, eyeballs and vision recovery. Results Eleven cases of sphenoid wing meningioma patients, the clinical manifestations of ipsilateral visual acuity decreased in 9 cases, 7 cases of eye protrusion, vi- sual field defect in 6 cases. MR] showed 7 cases of orbital cranial tumor, 4 cases of intracranial tu- mors, the largest diameter of the tumor 2.3cm-8.2cm. T1WI showed moderate and low signal, T2WI showed moderate and high signal, all tumors were evenly enhanced. Tumor and peripheral brain tis- sue boundary in 9 cases, border blur in 2 cases. Invasion of the optic nerve caused by optic nerve density, location changes in 7 cases. Surgical approach, including the cranial orbital zygomatic ap- proach and pterional approach, as far as possible during the removal of tumor, postoperative fol- low-up, visual impairment in postoperative visual acuity improved in 2 cases; in the patients with prominent eyes,3 cases rettLrned to normal after operation,and 4 cases had decreased eyes promi- nence; 3 cases of postoperative vision improved. Conclusions Sphenoid wing meningioma can oc- cur in all age groups, eye symptoms to vision loss, eyeballs, visual field defects, MRI imaging of TIWI mostly moderate and low signal, T2WI is medium and high signal. The tumor density is more consistent. Postoperative visual acuity depends on the preoperative residual vision, the better the prognosis of vision, the better eyeballs and visual field defects, the better prognosis.

关 键 词：蝶骨嵴脑膜瘤 临床特点 MRI 视功能预后 

分 类 号：R739.45[医药卫生—肿瘤]