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目的分析眼眶静脉性血管瘤的MRI、CT表现,提高对眼眶静脉性血管瘤的影像学认识。资料与方法对49例经手术病理证实的眼眶静脉性血管瘤患者的MRI、CT资料进行回顾性分析。结果 49例中,位于眼眶前部1例,肌锥内间隙18例,肌锥外间隙3例,肌锥内外间隙同时受累27例。MRI扫描41例显示为边界清楚但不光滑,形状不规则的不均质肿块。6例肿物边界不清。与眼外肌相比,T1WI呈低或等信号,T2WI呈高信号,肿瘤内部或周边可见血管流空信号。T2WI脂肪抑制序列高信号不被抑制。46例眼球明显向前突出,7例显示眼球受压变形。29例显示病变沿眼球壁生长呈铸形。15例显示眶尖脂肪间隙消失。7例可见肿物向颅内蔓延。14例具有急性突眼病史者显示出血信号,7例可见液-液平面。CT扫描显示为不均匀的较高密度。5例显示单个或多个的静脉石。26例眶骨受压,眼眶扩大。10例显示眶上裂扩大。结论眼眶静脉性血管瘤在MRI、CT上分别具有其特征性征象。CT对展示骨性结构及钙化有优势,而MRI对肿瘤的内部形态及其与周围组织结构关系的进一步判断更具意义。MRI在定位和定性诊断上优于CT。
Objective To analyze the MRI and CT findings of orbital venous hemangioma and to improve the imaging understanding of orbital venous hemangioma. Materials and Methods MRI and CT data of 49 cases of orbital venous hemangiomas confirmed by surgery and pathology were retrospectively analyzed. Results Among the 49 cases, there were 1 case in front of orbit, 18 cases of internal cone of muscle, 3 cases of external cone of muscle and 27 cases of internal and external interspace of muscle. MRI scans in 41 cases showed a distinct but not smooth, irregularly shaped, heterogeneous mass. Six cases of tumor boundary is unclear. Compared with extraocular muscles, T1WI showed low or equal signal, T2WI showed high signal inside or around the tumor visible vascular flow signal. T2WI fat suppression sequence high signal is not inhibited. 46 cases prominent prominence of the eye, 7 cases showed compression of the eyeball deformation. 29 cases showed lesions along the eye wall growth was cast. 15 cases showed disappearance of orbital apex fat gap. 7 cases of visible tumor spread to the skull. Fourteen patients with a history of acute exophthalmos showed hemorrhagic signs, and seven showed fluid-fluid level. CT scans show a higher density of non-uniformities. Five patients showed single or multiple venous stones. 26 cases of orbital bone compression, orbital enlargement. Ten cases showed an enlargement of the superior orbital fissure. Conclusion Orbital venous hemangiomas have their own characteristic features on MRI and CT respectively. CT has the advantage of displaying the skeletal structure and calcification, while MRI is more meaningful for the further determination of the internal morphology of the tumor and its relationship with the surrounding tissue structure. MRI is superior to CT in localization and qualitative diagnosis.