眼眶海绵状血管瘤眼眶神经鞘瘤患者的CT MRI影像特征及诊断鉴别研究  

CT and MRI Features and Differential Diagnosis of Orbital Cavernous Hemangioma and Orbital Schwannoma

作　　者：连鹏 王利 张晖 吕朋 蒋士杰 LIAN Peng;WANG Li;ZHANG Hui(Xi'an People's Hospital/Xi'an Fourth Hospital,Shaanxi Xi'an 710004,China)

机构地区：[1]陕西省西安市人民医院/西安市第四医院医学影像中心,陕西西安710004

出　　处：《河北医学》2024年第11期1848-1853,共6页Hebei Medicine

基　　金：陕西省重点研发计划,(编号:2024SF-YBXM-232)。

摘　　要：目的:观察眼眶海绵状血管瘤、眼眶神经鞘瘤患者的计算机体层摄影(CT)、磁共振成像(MRI)影像特征及诊断鉴别价值。方法:选取2021年1月至2024年1月我院收治的眼眶海绵状血管瘤与眼眶神经鞘瘤患者82例,根据手术病理学诊断结果将患者分为海绵状血管瘤组(n=44)与神经鞘瘤组(n=38),所有患者术前均接受CT、MRI检查,比较两组患者CT、MRI影像特征及两种检查方法对眼眶海绵状血管瘤与眼眶神经鞘瘤的鉴别诊断价值。结果:CT检查显示海绵状血管瘤组患者软组织密度均匀、CT值≥50HU比例高于神经鞘瘤组(P<0.05)。MRI检查显示海绵状血管瘤组患者眼球壁变平、T1WI与T2WI等信号强度、T1WI与T2WI信号均匀、渐进性强化、TIC类型为平台型或流出型比例高于神经鞘瘤组(P<0.05)。MRI检查对眼眶海绵状血管瘤、眼眶神经鞘瘤的定性诊断符合率与定位诊断符合率均高于CT检查(P<0.05)。结论:眼眶海绵状血管瘤与眼眶神经鞘瘤患者的MRI影像特征具有较大差异,且MRI检查对眼眶海绵状血管瘤与眼眶神经鞘瘤的定性与定位诊断价值高于CT检查,可为临床诊断鉴别提供影像学依据。Objective:To observe the computed tomography(CT)and magnetic resonance imaging(MRI)features of patients with orbital cavernous hemangioma and orbital schwannoma,and value of the two methods in differential diagnosis.Methods:From January 2021 to January 2024,82 patients with orbital cavernous hemangioma and orbital schwannoma were admited to our hospital,and they were selected as the research subjects.Based on surgical and pathological results,the patients were divided into cavernous hemangioma group(n=44)and schwannoma group(n=38).All patients underwent CT and MRI examinations before surgery.CT and MRI features of the two groups were comparatively analyzed.The value of the two imaging methods in differential diagnosis of orbital cavernous hemangioma and orbital schwannoma was compared.Results:CT examination showed that the density of soft tissues in patients with cavernous hemangioma was uniform,and the proportion of CT values≥50HU was higher than that in patients with schwannoma(P<0.05).MRI examination showed that patients with cavernous hemangioma had flatter eyeball walls,with equal signal intensity on T1WI and T2WI,uniform and progressively enhanced signals on T1WI and T2WI.The proportion of plateau/outflow type TIC was higher than that in patients with schwannoma(P<0.05).The accordance rates of MRI were higher than those of CT for qualitative diagnosis and localization diagnosis of orbital cavernous hemangioma and orbital schwannoma(P<0.05).Conclusion:MRI features of patients with orbital cavernous hemangioma and orbital schwannoma are significantly different.MRI is superior to CT for qualitative diagnosis and localization diagnosis of orbital cavernous hemangioma and orbital schwannoma,and can provide an imaging basis for clinical diagnosis and differentiation.

关 键 词：眼眶海绵状血管瘤 眼眶神经鞘瘤 计算机体层摄影 磁共振成像 影像特征 诊断鉴别 

分 类 号：R739.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]