眼眶神经鞘瘤的影像学研究

目的 探讨眼眶神经鞘瘤的CT和MRI的影像学表现及诊断价值。方法 42例眼眶神经鞘瘤均经手术及病理证实。结果 42例中CT显示（1）球后视神经上方20例，视神经外侧9例（2例位于眶尖），视神经下方11例和内侧2例。（2）椭圆形和类圆形27例，分叶状或S形9例，哑铃形6例（其中5例经眶上裂向颅内蔓延）。（3）平扫显示肿瘤内均质高密度28例，不均质14例，其中5例肿瘤内有较大片状低密度区（囊变区）。37例MRI扫描中等T1、长T24例；等T1、短等长T2混杂信号29例；等T1等T24例。在37例MRI检查中35例行Gd-DTPA增强，3l例呈不均匀增强；4例均匀增强。显示肿瘤颅内蔓延5例。结论 CT和MRI能显示肿瘤的位置、形状和病变内部特征，可明确诊断，为手术治疗提供重要依据；而MRI在肿瘤的定性和定位诊断方面明显优于CT。     

38例眼眶神经鞘瘤的诊治分析

目的探讨眼眶神经鞘瘤的临床诊断和手术治疗方法。方法对1999年8月至2003年12月在北京武警总医院眼眶病研究所治疗的38例眼眶神经鞘瘤患者进行回顾性分析。结果38例中男性15例,女性23例,年龄9—65岁,平均22岁。其中行标准化A／B超检查者37例,CT扫描38例,MRI成像33例。手术入路的选择有外侧开眶（包括改良外侧开眶）26例,内外联合开眶2例,前路开眶4例,内侧开眶2例。其中肿瘤囊内切除21例,肿瘤整体切除15例,部分切除联合术后放射治疗2例。随访时间平均为23个月,手术并发症包括视力丧失1例,上睑下垂2例,眼球运动障碍2例。结论现代影像学检查方法尤其是MRI对眼眶神经鞘瘤的术前定性、定位诊断及对手术入路的选择提供可靠依据,熟练的手术方法和技巧可提高治愈率,减少手术并发症。     

眼眶神经鞘瘤的MRI影像研究

目的评价磁共振成像（megnetic resoance imaging,MRI）影像对于眼眶神经鞘瘤的诊断价值,并提出常见的MRI图像特征。方法收集我院病理确诊的眼眶神经鞘瘤62例,均为单眼发病,所有患者均行眼眶MRI检查,获取T1和T2加权像。注射钆喷酸葡胺后获取强化T1加权像。回顾性分析并比较所有MRI图像。结果眼眶神经鞘瘤常见的肿瘤形状为圆锥形（16例）、哑铃形（10例）、椭圆形（9例）和圆形（8例）。神经鞘瘤的好发部位为眶上部（17例）、眶内上方（12例）和眶尖部（12例）。在T1加权像,53例显示均一的等信号或伴小片状低信号区。强化T1加权像的图像特征与T2加权像具有相关性,增强类型可分为5类。最常见的增强类型是环形强化征,有18例。均匀增强和不均匀增强各为16例和26例。结论MRI对于眼眶神经鞘瘤具有重要的诊断价值,尤其是在使用造影剂后。MRI可清晰显示肿瘤的形状和位置。T1加权像无明显特异性。T2和增强的T1加权像可提供肿瘤的组织学信息。环形强化征可作为神经鞘瘤的靶特征。     

眼眶植物性异物的影像学表现

目的分析眼眶植物性异物的影像学表现,为临床治疗提供帮助。设计回顾性病例系列。研究对象手术证实眼眶内植物性异物患者10例。方法对10例眼眶植物性异物患者行CT检查,轴位CT扫描5例、冠位CT扫描1例,轴位 冠位CT扫描4例。2例行MRI。对上述病例的影像学表现进行回顾性分析。主要指标眼眶植物性异物的急性期、亚急性期和慢性期的CT和MRI表现。结果急性期2例CT显示植物性异物为低密度,周围无软组织增生;亚急性期4例(包括1例上述急性期病例转为亚急性期者)CT显示植物性异物为低密度伴周围炎性软组织增生;慢性期6例(包括1例上述急性期病例转为慢性期者)CT显示植物性异物为高密度机化影,周围有炎性肉芽肿包裹。1例亚急性期异物MRI在T_1WI、T_2WI显示偏低信号,1例慢性期肉芽肿在T_1WI、T_2WI显示为中等信号。结论CT扫描对于急性期、亚急性和慢性期植物性异物均能明确诊断,MRI没有明显优势。(眼科,2007,16:323-325)     

眼眶海绵状血管瘤与神经鞘瘤的CT鉴别诊断

目的 评价螺旋CT多期增强检查对于眼眶海绵状血管瘤和神经鞘瘤的鉴别诊断价值.方法 38例眼眶海绵状血管瘤和16例神经鞘瘤,均为单眼发病,所有患者均行CT平扫,其中23例海绵状血管瘤和10例神经鞘瘤行多期增强CT检查.观察肿瘤的增强方式.结果 所有海绵状血管瘤呈"渐进性强化",增强早期,56.5%(13/23)海绵状血管瘤增强起自一点,43.5%(10/23)起自多点,73.9%(17/23)增强点位于边缘,26.1%(6/23)位于中央,随时间延迟强化逐步向全肿瘤扩展;增强早期4例神经鞘瘤为均匀强化,5例为伴有小片状低密度区的不均匀强化,1例为囊性变不强化,囊壁强化,随时间延迟强化程度无明显无变化.两种肿瘤的强化方式差异有统计学意义(P＜0.01).结论 螺旋CT多期增强检查可有助于鉴别眼眶海绵状血管瘤和神经鞘瘤.     

眼眶内神经鞘瘤的临床病理分析

本文报告了眼眶内神经鞘瘤１６例，均经手术切除及病理检查证实，其中男性６例，女性１０例。发病年龄４—７０岁，平均４０岁。病程１月—５年。右眼１０例，左眼６例。视力０．１—０．５者４例；＞０．５者８例，＜０．１者４例。突眼者１２例，两眼突出度差值最大２３ｍｍ，最小２．５ｍｍ。病理组织学检查：ＡｎｔｏｎｉＡ型８例，ＡｎｔｏｎｉＢ型４例，混合型４例。本文还对眶神经鞘瘤的临床表现、病理特征以及鉴别诊断作了简要的讨论。     

眼眶神经鞘瘤临床分析

神经鞘瘤是由神经鞘细胞即施万细胞（雪旺氏细胞）增生形成的一种良性肿瘤，约占眼眶原发性肿瘤的3．7％～6．4％。武警总医院眼眶病研究所近4年来收治经病理确诊的眶内神经鞘瘤46例，现将临床治疗效果分析如下。     

CT与MRI在诊断眼眶神经鞘瘤的价值

目的 研究眼眶神经鞘瘤CT与MRI的各自影像表现特点,对比二者在眼眶神经鞘瘤诊断上的价值.方法 总结经手术后、组织病理学证实的24例眼眶神经鞘瘤的CT与MRI影像表现特点,根据诊断符合率,运用统计学处理,找出最适合诊断的检查方法.结果 眼眶神经鞘瘤的定位诊断上,MRI平扫和CT平扫的诊断符合率分别为100%和92%,MRI平扫与CT平扫(P=0.502>0.05)对比组之间的差异无统计学意义,定性诊断上,MRI平扫、MRI增强、CT平扫、CT增强诊断符合率分别为88%、91%、46%、47%,MRI平扫与CT平扫(P=0.008<0.01)、MRI增强扫描与CT增强扫描(P=0.036<0.05),对比组之间的差异具有统计学意义.结论 MRI(平扫+增强)扫描是诊断眼眶神经鞘瘤的有效方法.

Abstract：

Objective To find the suitable way to differ the orbital neurilemmoma according to the CT and MRI features. Methods Twenty-four cases orbital neurilemmoma were enucleated and diagnosis was proofed by pathological, the imaging features of CT and MRI were analyzed, and the effect of diagnosis were statistic analyzed. Finally, the most suitable way for image investigation on the CT and MRI were found. Results For the position diagnosis rate of orbital neurilemmoma from plain MRI scan, plain CT scan was 100%,92% respectively. Plain MRI scan and Plain CT scan(P =0.502>0.05), there was no statistical significance. For the qualitative diagnosis rate of orbital neurilemmoma from plain MRI scan, MRI(contrast enhancement), plain CT scan, CT(contrast enhancement)was 88%, 91%, 46%, 47% respectively. Plain MRI scan and Plain CT scan (P=0.008<0.01), MRI(contrast enhancement)and CT(contrast enhancement)(P =0.036<0.05), there were statistical significant differences. Conclusions Plain MRI scan combine contrast enhancement scan is an effective method to diagnose of the orbital neurilemmoma.     

CT与MRI在诊断眼眶神经鞘瘤的价值

目的 研究眼眶神经鞘瘤CT与MRI的各自影像表现特点,对比二者在眼眶神经鞘瘤诊断上的价值.方法 总结经手术后、组织病理学证实的24例眼眶神经鞘瘤的CT与MRI影像表现特点,根据诊断符合率,运用统计学处理,找出最适合诊断的检查方法.结果 眼眶神经鞘瘤的定位诊断上,MRI平扫和CT平扫的诊断符合率分别为100%和92%,MRI平扫与CT平扫(P=0.502>0.05)对比组之间的差异无统计学意义,定性诊断上,MRI平扫、MRI增强、CT平扫、CT增强诊断符合率分别为88%、91%、46%、47%,MRI平扫与CT平扫(P=0.008<0.01)、MRI增强扫描与CT增强扫描(P=0.036<0.05),对比组之间的差异具有统计学意义.结论 MRI(平扫+增强)扫描是诊断眼眶神经鞘瘤的有效方法.     

眼眶海绵状血管瘤与眼眶神经鞘瘤影像学鉴别诊断的研究

目的 研究眼眶海绵状血管瘤与眼眶神经鞘瘤影像学表现特点,探讨最适合鉴别区分二者的影像学检查方法.方法 总结经手术后、组织病理学证实的眼眶海绵状血管瘤25例与眼眶神经鞘瘤24例的B超、CDFI、CT、MRI,归纳各种检查方法所表现出来的影像学特点,对两种肿瘤进行鉴别诊断,以病理学诊断为标准,影像学诊断与之一致的为诊断符合;诊断符合率比较采用X2检验.总结出最适合鉴别这两种肿瘤的影像学检查方法.结果 眼眶海绵状血管瘤的诊断上,MRI(平扫+增强)扫描诊断符合率为100%,CT(平扫+增强)为93%,CDFI为87%,B超为80%.眼眶神经鞘瘤的诊断上,MRI(平扫+增强)诊断符合率为91%,CT(平扫+增强)为47%,CDFI为53%,B超为46%.结论 MRI(平扫+增强)扫描是有效鉴别此二种肿瘤的一种检查方法.     

Clinical and Imaging Findings in Multifocal Orbital Vascular Lesions: A Case Series

Introduction: A variety vascular disorders can affect the orbit, often manifesting as solitary space-occupying lesions. This study presents a case series of 3 patients with multi-focal orbital vascular conditions emphasizing on the clinical and imaging findings which could assist in the diagnosis and treatment planning.

Methods: Retrospective consecutive case series of 3 patients with multifocal orbital vascular conditions treated at the Department of Ophthalmology of the University Hospital of Heraklion, in Crete, Greece.

Results: Presenting symptoms included diplopia with compensatory head tilt (1 case) and eyelid protrusion enhanced by Valsalva maneuver (2 cases). MRI and CT studies showed multiple contrast-enhancing vascular lesions, associated with calcifications (1 case). Two lesions were surgically removed, proving to be orbital varices.

Conclusions: Orbital vascular lesions may present multi-focally and displace adjacent structures. MRI and CT imaging may reveal their multi-focal presence as well as associated features, such as phleboliths.     

Magnetic Resonance Imaging Findings in Divergence Paralysis

We report magnetic resonance imaging (MRI) findings in two patients with divergence paralysis that was secondary to multiple sclerosis and pontine infarction, respectively. In both patients, cranial MRI showed lesions in the unilateral tegmentum of the caudal pons. Therefore, these MRI findings suggested that involvement of the nucleus reticularis tegmenti pontis might be responsible for the divergence paralysis in our cases.     

眼眶囊肿70例影像学诊断分析

目的 探讨眼眶囊肿的影像诊断特征.方法 回顾性分析经手术组织学证实的眼眶囊肿70例的B超、CT、MRI的表现.结果 B超、CT、MRI在眼眶囊肿中均有特征性表现,B超可以确定病变的声学性质,揭示病变内的组织结构.CT能够准确空间定位并可揭示骨缺失等继发改变.MRI可通过不同信号强度提示病变的组织结构,并可清楚显示眶颅沟通性病变.结论 联合应用B超、CT及MRI多种检查方法在眼眶囊肿的诊断中有重要价值.     

Color Doppler Imaging of the Orbital Vessels in Ankylosing Spondylitis

Abstract

Purpose: To analyze the hemodynamic features of orbital blood flow velocities using Doppler ultrasonography in ankylosing spondiylitis (AS) patients, as well as to compare these results with those of healthy controls. Methods: 33 AS patients and 32 healthy controls were consecutively included in the study groups. The same radiologist performed ocular blood flow measurements. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) were measured in the central retinal artery (CRA), posterior ciliary arteries (PCAs), and ophthalmic artery (OA). Resistive index was used to assess arterial resistance; it was automatically calculated as RI [(PSV–EDV)/PSV]. Results: There were no significant differences in the PSV, EDV, and RI of the OA, CRA, and PCAs between AS patients and controls. Conclusion: This result suggests no possible contributory role of vascular structures in formation of uveitis in AS. We believe that our preliminary results need to be complemented with further studies, particularly including AS patients with uveitis and rheumatic diseases with other ocular involvement.     

磁共振成象术对眼内与眼眶肿瘤的诊断作用

本文报告18例眼内肿瘤（10例视网膜母细胞瘤，8例脉络膜黑瘤）及12例眼眶肿瘤（炎性假瘤6例，恶性肿瘤4例，血管瘤2例）的磁共振检查，结合临床组织学结果，我们发现磁共振成象术对眼内脉络膜黑色素瘤及眼眶肿瘤诊断较为可靠与准确。