痛性眼肌麻痹综合征的CT、MR表现  

CT and MR findings of Tolosa-Hunt syndrome

作　　者：李斌 陈武标 李新华 符有文 陈晓东 LI Bin;CHEN Wubiao;LI Xinhua;FU Youwen;CHEN Xiaodong(Department of Radiology,the Affiliated Hospital of Guangdong Medical University, Zhanjiang,Guangdong Province 524001,China)

机构地区：[1]广东医科大学附属医院放射科,广东湛江524001

出　　处：《实用放射学杂志》2019年第10期1587-1589,共3页Journal of Practical Radiology

摘　　要：目的分析痛性眼肌麻痹综合征(THS)的CT和MR表现,提高对此病的诊断能力。方法回顾性分析经临床确诊的16例THS的CT和MR资料。结果 16例中11例异常,表现为单侧海绵窦不对称性肿大,形态多不规则,外缘较光滑平直或稍膨隆,内缘无明确边界。病灶最大径1.2~3.8 cm,平均(2.3±0.9) cm。10例CT平扫呈均匀等密度,增强扫描明显强化。6例MR平扫T1WI呈等信号、T2WI呈等或低信号,3例DWI呈等信号,信号均匀,增强扫描明显强化。5例沿同侧视神经向眶尖蔓延。4例颞部硬脑膜局限性增厚且明显强化。2例岩上静脉增粗,1例大脑中静脉增粗。结论单侧海绵窦不对称性增大,排除其他疾病时,应考虑THS诊断。病灶密度或信号较均匀,增强检查明显强化,沿视神经向眶尖蔓延,同侧颞部硬脑膜局限性增厚及岩上静脉增粗是有价值的影像特点。MR对THS的显示较CT有优势。Objective To analyze CT and MRI features of Tolosa-Hunt syndrome (THS),to improve the diagnostic accuracy of this lesion.Methods CT and MRI findings of 16 patients with THS confirmed clinically were studied retrospectively. Results Eleven out of 16 cases' images were abnormal .including unilateral sinus cavernous enlarged asymmetrically, irregular shapes,the outer edges being smooth and straight or slightly bulging,and the inner edges without clear boundary.The maximum diameters of the lesions varied from 1.2 to 3.8cm,with an average of (2.3±0.9)cm. Ten cases of CT examination showed uniform densities with significant enhancement after enhanced scan.Six patients underwent MR scan and showed equal signals on T1WI with equal or low signals on T2WI,equal signals on DWI in 3 patients and obvious enhancement after contrast agent was injected.Among 6 cases with MR examination,were found to spread along the ipsilateral optic nerve to the orbital apex,4 temporal dura mater were thickened locally and obvious enhancement, 2 super petrosal veins were thickened,and 1 middle cerebral vein was thickened.Conclusion The diagnosis of THS should be considered when the unilateral cavernous sinus is increased asymmetrically,and other diseases arc excluded.The helpful imaging feature includes relatively uniform density or signal of the lesion,significant enhancement,the lesion spreading along the optic nerve to the tip of the sac,and the thickening of temporal dura mater and super petrosal vein in the same lateral.The display of THS by MR seems to be superior to CT.

关 键 词：痛性眼肌麻痹综合征 计算机体层成像 磁共振成像 

分 类 号：R777.45[医药卫生—眼科] R814.42[医药卫生—临床医学]