眼眶炎性假瘤的CT诊断和鉴别诊断(附40例分析)

目的：旨在描述炎性假瘤的ＣＴ表现,提高对本病诊断和鉴别诊断水平。方法：分析４０例经手术病理或临床证实的炎性假瘤ＣＴ资料。结果：４０ 例炎性假瘤有５９个区域被累及按主要受累部位分四型：眼肌型、泪腺型、球后型、混合型。炎性假瘤ＣＴ特征性表现为：（１）眼肌肥大为眼肌全程肥大（包括眼肌前部肌腱处）;（２）眼球后脂肪、眶内标志完全消失。结论：具典型ＣＴ表现,炎性假瘤诊断不难;缺乏典型ＣＴ表现,需结合临床、有时需做病理活组织检查才能诊断,并且需与其它病变相鉴别。     

CT、MRI在眼眶炎性假瘤的诊断价值

目的:探讨CT和MRI对眼眶炎性假瘤的诊断和鉴别诊断价值。方法:回顾性分析经临床、病理证实的63例眼眶炎性假瘤的影像学表现。结果:根据病变累及部位及形态学表现分为:①隔前型2例,表现为眼睑肿胀;②巩膜周围炎型1例,表现为眼球壁增厚;③视神经束膜炎型3例,表现为视神经增粗;④弥漫型10例,病变可同时累及眶隔前组织、眼肌、视神经、眼环、泪腺、眶内脂肪或眶周组织;⑤肿块型12例,表现为边界清楚的肿块;⑥泪腺炎型9例,表现为泪腺肿大;⑦肌炎型26例,表现为1条或数条眼外肌增粗、肥大。结论:CT和MRI能对眼眶炎性假瘤确切定位及分型,为临床治疗方案提供重要依据,二者的结合极大地提高了眼眶炎性假瘤的正确诊断率。     

CT、MRI在附睾肿块诊断中的应用价值

 目的 探讨附睾肿块的临床特点和CT、MRI表现.方法 回顾性分析42例经手术病理证实的附睾肿块的临床表现和CT、MRI特点.结果 附睾囊肿13例,附睾非特异性炎性肿块11例,结核8例,精子性肉芽肿4例,平滑肌瘤2例,纤维假瘤1例,腺瘤样瘤3例;附睾囊肿及结核的影像表现有一定特征性;MRI对于附睾炎性肿块、平滑肌瘤、纤维假瘤的诊断有较大帮助.结论 附睾肿块大多为良性病变;正确认识附睾肿块的CT、MRI表现,对附睾肿块的早期诊断及治疗有较高的临床价值,少数附睾肿块缺乏影像特征性,依赖病理确诊.     

颅内炎性假瘤的影像表现

目的：探讨颅内炎性假瘤的田、MRI表现及诊断价值。方法：对16例颅内炎性假瘤的病人行CT及MRI检查。结果：颅内炎性假瘤的影像表现为：1．病灶小、呈结节状或厚壁小环状；2．CT平扫呈等密度或略高密度结节，可伴有小点钙化，MRI平扫呈等TIWI信号，T2WI呈略高或高信号，增强扫描可见早期的强化或延迟性强化。3．灶周水肿较轻。4．无明显占位效应或伴有轻度脑萎缩表现；16例病人经临床诊断及手术病理证实。结论：CT及MRI对颅内炎性假瘤的诊断有重要的临床价值。     

眼眶占位性病变的CT诊断与手术方式的相关性分析

目的：探讨眼眶占位性病变的CT影像特点，从而指导治疗及手术方式的选择。方法：分析我院主要经手术、病理证实的59例眼眶占位性病变的CT征象、临床资料及手术方式。结果：眼眶原发良性肿瘤35例，原发恶性肿瘤6例，炎性假瘤11例，颈动脉海绵窦瘘7例。7例颈动脉海绵窦瘘经CT及DSA诊断明确并行栓塞治疗，41例眼眶肿瘤及8例炎性假瘤在CT定性、定位结论的指导下行手术治疗均完整切除肿块，另2例肌炎型及1例肿块型炎性假瘤经皮质激素治疗后明显缓解。结论：CT可对眶内病变进行准确定位并估计病变的性质，为治疗及手术进路的选择提供了有价值的参考。     

脾脏炎性假瘤CT和MRI表现与病理对照分析

目的:探讨脾脏炎性假瘤的CT、MRI表现,提高CT、MRI对该病的认识和诊断水平。方法:回顾性分析经临床手术病理证实的6例患者的临床、CT、MRI资料,6例均行CT、MRI平扫及增强扫描,分析其CT、MRI表现特征并与病理结果对照。结果:脾脏炎性假瘤的MRI表现:T1WI序列表现为低或等信号,T2WI序列为低信号,信号特点与纤维组织增生、灶性出血、凝固性坏死、含铁血黄素沉着等有关。CT表现:CT平扫表现为等密度或稍低密度、边界清晰的肿块,其内可见散在点状高密度出血灶、小片状低密度坏死区。CT、MRI动态增强后各期强化不明显。CT、MRI可见病灶周围有不完整包膜。本组炎性假瘤病理以大量纤维组织增生为特征,间以淋巴细胞、浆细胞、组织细胞以及单核细胞等慢性炎性细胞浸润,伴以灶性出血、凝固性坏死、含铁血黄素沉着等。本组脾脏炎性假瘤CD68(巨噬或单核细胞标记物)均为阳性。结论:脾脏炎性假瘤具有特征性CT、MRI表现,CT、MRI对脾脏炎性假瘤的诊断及鉴别诊断具有重要价值。     

脾脏炎性假瘤样滤泡树突细胞瘤的CT、MRI表现

目的 探讨脾脏炎性假瘤样滤泡树突细胞瘤的CT、MRI特征,以提高对该病的认识。方法 选取分析5例经手术病理证实的脾脏炎性假瘤样滤泡树突细胞瘤的CT、MRI表现,与术后病理结果比较、并复习相关文献,总结脾脏炎性假瘤样滤泡树突细胞瘤的CT、MRI影像学特征。结果 5例炎性假瘤样滤泡树突细胞瘤表现为类圆形单发肿块,肿块较大,直径5～11 cm,边界清晰,密度、信号欠均匀,5例肿块均有坏死,3例合并中央瘢痕,增强扫描动脉期显示病灶边缘强化,门静脉期病灶呈渐进性持续强化并向中央填充,坏死无强化,中央瘢痕延迟强化。结论 脾脏炎性假瘤样滤泡树突细胞瘤的中央瘢痕,增强扫描具有渐进性、持续性强化的特点,具有一定影像学特征,确诊需镜检及免疫组织化学检查。     

儿童突眼的CT诊断

目的　探讨儿童突眼的CT表现特点。方法　对 3 1例儿童突眼患者的眶部CT表现进行回顾性分析。 3 1例中 2 5例经手术病理证实 ,6例为临床随访。结果　眶内炎症 5例 ,其中蜂窝织炎 2例、肌锥外脓肿 1例、炎性假瘤 2例。眶内肿瘤 2 6例 ,其中毛细血管瘤 4例 ,皮样囊肿 3例 ,视神经胶质瘤 3例 ,神经鞘瘤 1例 ,骨化性纤维瘤 1例 ,横纹肌瘤 1例 ,神经纤维瘤病Ⅰ型 2例 ,泪腺混合瘤和腺样囊性癌各 1例 ,横纹肌肉瘤 5例 ,视网膜母细胞瘤 3例 ,转移性神经母细胞瘤 1例。结论　儿童突眼的CT表现各有其特点 ,结合临床多数可作出定性诊断     

肝脏炎性假瘤CT诊断2例报告

肝脏炎性假瘤ＣＴ诊断２例报告大连医学院附属一院放射科刘爱莲，丁昭岐，郎志谨，杜长春大连市友谊医院外科付维利炎性假瘤以肺最常见，亦可发生在眼眶、腮腺、胸膜、胃、卵巢等器官，发生在肝脏者不多。现将经ＣＴ、手术和病理证实的２例肝脏炎性假瘤报导如下：例１，男...     

CT扫描对眼眶炎性假瘤的诊断价值

目的　探讨CT扫描对眼眶炎性假瘤的诊断价值。方法　对 2 1例经临床、病理及手术证实的眼眶炎性假瘤作回顾性分析。结果　CT征象包括眼球突出、眼外肌增粗、眼环增厚、视神经增粗、眶内脂肪密度增高、泪腺肿大、合并鼻副窦炎等。结论　CT扫描对眼眶炎性病变的诊断有重要价值。     

MR Imaging of Orbital Inflammatory Pseudotumors with Extraorbital Extension

Objective

To demonstrate a variety of MR imaging findings of orbital inflammatory pseudotumors with extraorbital extension.

Materials and Methods

We retrospectively reviewed the MR features of five patients, who were diagnosed clinically and radiologically as having an orbital inflammatory pseudotumor with extraorbital extension.

Results

The types of orbital pseudotumors were a mass in the orbital apex (n = 3), diffuse form (n = 2), and myositis (n = 1). The extraorbital extension of the orbital pseudotumor passed through the superior orbital fissure in all cases, through the inferior orbital fissure in two cases, and through the optic canal in one case. The orbital lesions extended into the following areas: the cavernous sinus (n = 4), the middle cranial fossa (n = 4), Meckel''s cave (n = 2), the petrous apex (n = 2), the clivus (n = 2), the pterygopalatine fossa and infratemporal fossa (n = 2), the foramen rotundum (n = 1), the paranasal sinus (n = 1), and the infraorbital foramen (n = 1). On MR imaging, the lesions appeared as an isosignal intensity with gray matter on the T1-weighted images, as a low signal intensity on the T2-weighted images and showed a marked enhancement on the post-gadolinium-diethylene triamine pentaacetic acid (post-Gd-DTPA) T1-sequences. The symptoms of all of the patients improved when they were given high doses of steroids. Three of the five patients experienced a recurrence.

Conclusion

MR imaging is useful for demonstrating the presence of a variety of extraorbital extensions of orbital inflammatory pseudotumors.     

Imaging of inflammatory pseudotumors of the liver

PURPOSE: To describe the imaging features of inflammatory pseudotumors of the liver. INTRODUCTION: Inflammatory pseudotumors of the liver are rare benign lesions that may simulate malignancy on imaging studies. Diagnosis is most frequently confirmed after surgical resection of the lesion. MATERIALS AND METHODS: Retrospective study from 1998 to 2006 of histologically proven cases of inflammatory pseudotumors of the liver. A combination of the following imaging modalities were utilized: US, contrast enhanced US, helical CT and MRI. RESULTS: A total of seven lesions (mean diameter of 61.4 mm) were detected in 6 patients (mean age of 66 years). Clinical and laboratory results were non-specific. The following imaging studies were available: US in 5 cases, including one with contrast material, CT in 5 cases and MRI in 3 cases. All tumors were hypoechoic on US, with no enhancement after injection of Levovist. The tumors were generally hypodense on noncontrast CT and enhancement, when present, was delayed and moderate. On MRI, the tumors were iso- or slightly hyperintense on T2W images and iso- or slightly hypointense on T1W images with subtle peripheral enhancement on delayed imaging. CONCLUSION: The differential diagnosis of inflammatory pseudotumor of the liver should be known to radiologists and could be suggested in a clinical context of chronic inflammatory process in patients with non-specific liver mass showing imaging features of partial fibrosis with delayed enhancement.     

Imaging of orbital lymphoproliferative disorders

Lymphomas and leukemias account for a large portion of orbital tumors. Orbital lymphoma accounts for 55% of malignant orbital tumors in adults. Idiopathic orbital inflammatory pseudotumors are pathologic entities that often challenge ophthalmologists and radiologists. This article describes the MR and CT features of orbital lymphoma, leukemia, and some other lymphoproliferative disorders.     

Idiopathic orbital pseudotumour

Idiopathic orbital pseudotumour (IOP) is a benign inflammatory condition usually confined to the orbit. This may involve single or multiple intraorbital structures. Extraorbital extension can also occur. The imaging appearances often mimic other orbital diseases. Both computed tomography (CT) and magnetic resonance imaging (MRI) are frequently used to investigate orbital diseases, and it is important for radiologists to be aware of the variety of imaging appearances that occur in IOP. We present the imaging appearances in histopathologically confirmed cases of IOP and discuss the clinical features, natural history, and differential diagnosis of this condition.     

眶颅沟通性病变的CT和MRI研究

目的 研究、探讨眶颅沟通性病变的沟通路径、CT和MRI表现及其影像学特征。方法 51例患者,男28例,女23例,年龄2－68岁,平均41岁,为手术病理和随访结果证实。51例均行 CT扫描,45例行MR扫描,CT和MR增强扫描各44例。结果 通过眶上裂或视神经管沟通的颅眶沟通笥病变31例,占60.8％。其中9例通过视神经管沟通,包括4例视神经和视交叉胶质瘤、3例视神经鞘脑膜瘤,以及2例视网膜母细胞瘤侵犯视神经和视交叉;通过眶上裂沟通者,包括5例脑膜瘤、4例神经源性肿瘤、2例Tolosa-Hunt综合征、3例炎性假瘤、1例眼眶和海绵窦皮样囊肿,以及7例鼻咽癌同时侵犯海绵窦和眼眶,通过眶骨穿支血管间隙沟通的病变或骨质破坏缺损区沟通的眶颅沟通性病变20例,占39.2％,包括5例眶骨扁平性脑膜瘤、10例眶壁转移瘤、1例眶壁软骨肉瘤侵犯筛窦、额窦和额叶、3例泪腺囊腺癌侵犯颅内和1例额底脑膜瘤侵犯眼眶。结论 CT和MRI,尤其是使用脂肪抑制技术和增强扫描的T1WI能明确显示眶颅沟通性病变的沟通路径和病变特征,为制订治疗方案和手术入路提供重要和直接的依据。     

脑脱髓鞘假瘤MRI与临床病理对照研究(3例报告并文献复习)

目的探讨脑脱髓鞘假瘤的磁共振影像学特征与临床病理的关系。方法搜集经病理证实的脑脱髓鞘假瘤3例,结合文献复习其MR形态及信号特点,并与病理及临床症状对照。结果本组3例(男2例,女1例)患者发病年龄24～68岁,发病前无明确的前驱感染史或诱因,3例患者中,其中2例为单发,1例位于双额叶,1例位于右颞叶,另1例为颅内多发病灶,MRI T2WI呈稍低信号,T1WI呈低信号为主,增强后呈半环形或斑片状强化,其中1例合并出血性改变,病理上表现为典型脱髓鞘、炎性浸润及反应性细胞增多,多数可见具有核分裂状的肥胖型胶质细胞。结论颅内炎性脱髓鞘假瘤的MRI影像学表现具有一定的特点,增强扫描及扩散加权技术有助于脱髓鞘假瘤的诊断及鉴别诊断。     

Orbital syndromes--CT analysis of 100 cases

100 cases of orbital syndromes, primary or secondary, are reviewed after CT analysis and compared with the results of plain and angiographic conventional examinations. First, the technique and normal results are described. Primary orbital syndromes (45 cases) originating in the orbit form three subgroups--tumors of the eyeball, tumors limited to the orbit and tumors of the orbit with bone lesions, with or without extra-orbital extension. Secondary orbital syndromes (55 cases) spreading to the orbit contain malignant tumors (36 cases) of which 25 are epitheliomas and benign tumors, the most frequent being meningiomas. For ocular and orbital tumors, CT allows the diagnosis of a mass and sometimes the pathological diagnosis (endocrine exophtalmos, inflammatory pseudotumors, varicose ophthalmic veins). For all other orbital tumors CT is important in determining the volume, relationships and extension, and does so better than carotid angiography or orbital phlebography. In secondary orbital syndromes, and particularly in facial malignant tumors and in meningiomas, CT is of great interest in the pretherapeutic evaluation of a tumor. It shows its volume and extension toward the face and orbital cavities, the pterygo-maxillary fossa (so important in determining the operability), the infra-temporal fossa and the endocranium, often without resorting to complementary investigational procedures which are much more aggressive. After histological diagnosis, CT allows the establishment of a therapeutic program.     

MRI of idiopathic orbital inflammatory syndrome using fat saturation and Gd-DTPA

Idiopathic orbital inflammatory syndrome encompasses a group of inflammatory conditions for which no systemic or local cause can be found, and is commonly referred to as orbital pseudotumour. On conventional MRI sequences subtle areas of inflammation or enhancing tissue can easily be masked by the high signal intensity of orbital fat and involvement of the fat itself may not be appreciated. We describe the MRI features of three patients with idiopathic orbital inflammation using frequency-selective fat saturation and Gd-DTPA.     

Computed tomography of masses in the lacrimal gland region.

Twenty patients with mass lesions in the lacrimal gland region were evaluated with computed tomography (CT). The extent of the mass and its relationship to the globe, optic nerve, and extraocular muscles were clearly seen. The CT appearance on plain scan and the presence or absence of contrast enhancement, bone involvement, and cystic components often suggested the specific pathological diagnosis. Although orbital ultrasonography and CT were frequently complementary, ultrasonography was more definitive in inflammatory diseases, while CT demonstrated better extraorbital extension.