CT、MRI在视网膜母细胞瘤的诊断价值

目的:探讨视网膜母细胞瘤的CT和MRI表现及其在诊断与鉴别诊断中的价值.方法:回顾性分析经病理证实的27例视网膜母细胞瘤的CT及MRI表现,所有病例均行CT检查,9例行MRI检查.结果:CT显示眼球内软组织肿块21例,其中眼球内单发肿块14例,多发肿块7例;肿块突破眼环进入球外5例,视神经增粗2例;颅内侵犯1例;视网膜脱离1例;伴钙化24例.MRI显示眼球内肿块5例;眼球内外肿块3例,视神经增粗3例;沿视神经侵犯颅内1例;伴视网膜脱离2例;钙化灶4例.结论:CT对视网膜母细胞瘤的定性诊断有重要意义,MRI对视网膜母细胞瘤的分期及显示视网膜脱离较好.     

视网膜母细胞瘤的CT诊断

目的 探讨视网膜母细胞瘤的CT特征、诊断和鉴别诊断。方法 回顾性分析31例（32只眼）资料完整经病理或临床证实的视网膜母细胞瘤临床和CT检查资料。结果 视网膜母细胞瘤的典型临床表现为白瞳、眼球突出等，CT表现为：a）眼球后部软组织肿块．b）点状、斑片状钙化，钙化率93.8％；c）眼球突出；d）视神经增粗，眼环增厚，提示球外蔓延。结论 CT对视网膜母细胞瘤的诊断及分期有重要价值，瘤体内钙化斑是视网膜母细胞瘤的特征性CT表现。     

视网膜母细胞瘤的CT诊断

目的　研究视网膜母细胞瘤的CT诊断及鉴别诊断。方法　分析经手术病理证实的 2 5例视网膜母细胞瘤的CT表现。结果　所有病例均表现为玻璃体部分或全部密度增高。钙化 2 3例 ;眼球增大 8例 ;视神经受累 6例 ;异位视网膜母细胞瘤 7例。结论　CT对视网膜母细胞瘤可做出定性诊断     

视网膜母细胞瘤的CT诊断

目的:探讨视网膜母细胞瘤CT表现及其特征。材料和方法:回顾性分析11例经临床和手术病理证实的视网膜母细胞瘤的CT表现。结果:视网膜母细胞瘤CT表现为眼球后壁软组织肿块11例,其中肿块内有钙化9例,玻璃体密度增高8例,突眼6例,视神经增粗4例,颅内侵犯和转移2例。术前定性准确率为81．8％,分期准确率为73％。结论:视网膜母细胞瘤的CT表现具有特征性,CT检查对本病具有重要价值。     

眼球内肿瘤的CT表现

目的：探讨常见眼球内肿瘤的CT表现及其在诊断与鉴别诊断中的价值。方法：分析经手术病理证实的47例眼球内肿瘤的CT表现,其中平扫47例、平扫加增强扫描37例。结果：视网膜母细胞瘤29例,CT表现自眼环生长的软组织肿块并钙化为本病特征表现,葡萄膜黑色素瘤13例,脉络膜血管瘤1例,脉络膜转移瘤2例,CT均表现起自眼环的软组织肿块,无钙化;脉络膜骨瘤2例,CT表现眼环类圆形骨密度肿瘤。结论：CT可确定眼球内肿瘤的位置并提示肿瘤的性质,对视网膜母细胞瘤进行确切的诊断及分期,为临床制定治疗方案提供依据。     

视网膜母细胞瘤的CT诊断

目的探讨视网膜母细胞瘤CT表现特征。方法回顾性分析52例（56只眼）经临床和手术或穿刺病理证实的视网膜母细胞瘤的CT表现。结果视网膜母细胞瘤CT表现为眼球后壁软组织肿块52例（56只眼）,钙化率95％,视神经增粗3例（4只眼）,颅内转移3例,远处转移3例。分期准确率为77％。结论视网膜母细胞瘤的CT表现具有特征性,CT检查对本病具有重要价值,对于临床治疗有重要的指导意义。     

视网膜母细胞瘤的CT诊断价值

目的 分析视网膜母细胞瘤的CT表现,进一步认识CT在其诊断中的应用价值。资料与方法 回顾性分析9例经手术病理或随访证实的视网膜母细胞瘤临床和CT资料。结果 9例患儿均可见眼球后部实质肿块：8例伴有钙化,其中团片状钙化6例,斑点状钙化2例;眼球突出5例,视神经增粗2例,颅内侵犯1例。结论 CT对视网膜母细胞瘤的诊断、分期、手术及判断预后提供了客观依据。     

视网膜母细胞瘤和Coat’s病CT征象的研究

目的：本文旨在探讨视网膜母细胞瘤与Coat’s病的不同CT表现，提高诊断和鉴别诊断能力。材料和方法：12例视网膜母细胞瘤和5例Coat’s病经手术病理证实，均在术前接受CT检查。CT为2毫米层厚连续扫描，并给予团注法增强检查。结果：两者均有软组织肿块和玻璃体密度增高．但视网膜母细胞瘤除绝大多数有钙化外．还有眼球增大，晶状体密度减低和移位的表现。结论：多数情况下．根据有无钙化可将两者区别开来．少数无钙化视网膜母细胞瘤还需根据眼球大小和晶体状改变加以区别。     

视网膜母细胞瘤的影像学表现及其临床价值

目的　探讨视网膜母细胞瘤的CT、MRI表现及其诊断、鉴别诊断价值。方法　回顾性分析 3 2例经手术病理 (2 9例 )和临床证实 (3例 )的视网膜母细胞瘤。所有病例均行CT检查 ,11例行MRI检查。结果　具有典型CT表现者 2 8例 :①眼球壁上软组织密度块影向球内隆起 ;②斑点状或团块状钙化。 3例视神经增粗 ,其中 1例伴鞍上肿块。 4例瘤内无钙化。MRI显示 11例球内肿块同时伴有视网膜下积液、出血 2例 ,显示有低信号钙化灶 2例 ,视神经增粗 2例。CT与MRI检查对视网膜母细胞瘤敏感性相同。定性诊断准确率 :CT 90 .63 % (2 9/3 2 ) ,MRI 81.82 % (9/11)。分期准确率 :CT 93 .10 % (2 7/2 9) ,MRI 10 0 % (9/9)。结论　CT对肿瘤定性诊断具有重要意义。MRI检查对肿瘤分期较优越。对无钙化肿瘤辅以MRI检查可提高定性诊断准确率     

先天性肝母细胞瘤CT表现及误诊分析

目的 探讨先天性肝母细胞瘤(CHB)的CT特征,分析误诊原因,提高对CHB的认识和诊断能力.资料与方法 回顾性分析经手术病理证实的7例新生儿CHB的临床及CT表现,并与易误诊病变进行鉴别诊断.结果 7例新生儿CHB中,1例甲胎蛋白阳性.7例CHB均为肝内单发肿块;最大径2.9～10.2 cm(中位值4.7 cm);类球...     

眼球肿瘤的CT表现

目的 研究眼球肿瘤的CT表现,并探讨其在诊断和鉴别诊断中的价值。材料与方法 回顾性分析22例经病理或临床证实的眼球肿瘤的CT表现。结果 成视网膜细胞瘤14例,脉络膜黑色素瘤5例,睫状体神经鞘瘤1例,脉络膜骨瘤1例,脉络膜血管瘤1例。其CT表现各具有特征。结论 CT可清楚显示眼球肿瘤的形态、大小和强化特征,为诊断和鉴别提供重要依据。     

MR imaging of intraocular lesions--a comparison with CT]

Thirty-two intraocular lesions were studied with magnetic resonance (MR) imaging and computed tomography (CT). These lesions included retinoblastoma (n = 11), uveal melanoma (n = 6), metastatic choroidal tumor (n = 3), choroidal hemangioma (n = 2), retinochoroiditis (n = 6) and Coats' disease (n = 4). MR imaging was superior to CT in the depiction of intraocular masses and retinal detachment. Gd-DTPA enhanced MR imaging was more useful than contrast enhanced CT in evaluating the contrast enhancement of intraocular tumors. Differential diagnosis of intraocular tumors was difficult with both MR imaging and CT. Intratumoral calcification was noticed on CT in nine cases of retinoblastoma. It was concluded that MR imaging, including contrast enhancement study, is more useful than CT in the evaluation of intraocular lesions, except for calcification, and contrast enhanced CT may be unnecessary in the diagnosis of intraocular lesions.     

眼脉络膜黑色素瘤的CT表现及其病理基础探讨

本文对比分析９例眼内期脉络膜黑色素瘤的ＣＴ表现和病理学改变。ＣＴ图像上脉络膜黑色素瘤表现为突向玻璃体腔的高密度肿块或眼环局限性梭形增厚。肿块较小，未破坏Ｂｒｕｃｈ膜时，呈扁平梭形。破坏Ｂｒｕｃｈ膜后，ＣＴ上表现为半圆形、圆形病灶。肿瘤密度接近眼环，多有中度强化。文中还对继发性视网膜脱离的ＣＴ表现及诊断价值进行了探讨。     

Intraocular tumors: evaluation with MR imaging

Sixty-seven ocular tumors were studied with magnetic resonance (MR) imaging and computed tomography (CT). These tumors included primary uveal melanoma (n = 55), circumscribed choroidal hemangioma (n = 3), diffuse choroidal hemangioma (n = 1), retinal capillary hemangioma (n = 1), medulloepithelioma (n = 1), choroidal nevus (n = 1), retinoblastoma (n = 1), and choroidal metastases (n = 4). MR imaging demonstrated all these lesions, while CT demonstrated 88%. Associated retinal detachment was more easily distinguished from the neoplasms with MR imaging. Extrascleral extension of melanoma and hemorrhagic cystic necrosis within the melanoma were clearly demonstrated with MR imaging, but not with CT. Ninety-three percent of melanomas were markedly hyperintense, compared with the intensity of the vitreous body, on T1-weighted images and hypointense on T2-weighted images. All metastatic lesions were isointense on T1-weighted images and hypointense on T2-weighted images. The circumscribed choroidal hemangiomas were hyperintense on T1-weighted images and isointense on T2-weighted images. MR imaging is superior to CT in detection of intraocular tumors and may be more specific in diagnosis.     

Magnetic resonance imaging in lesions of the eye globe

Magnetic Resonance Imaging (MRI) findings in 22 patients with lesions of the globe were examined. There were 16 cases of malignant uveal melanoma, 2 cases of retinoblastoma, 3 cases of hemorrhagic choroidal detachment and 1 case of senile macula degeneration. MRI adequately depicted the lesions in 20 cases. In two cases MRI findings were unconclusive due to movement artifacts of the eye globe. Fourteen out of 16 uveal melanomas displayed typical T1 and T2 shortening. In the two other cases the hypointense aspect on T2-weighted images was less pronounced due to a lesser amount of melanin in the lesions as demonstrated by subsequent histology. Unlike with CT, the tumoral lesions could clearly be differentiated from subretinal exudate. The case of senile macula degeneration, two retinoblastomas and two cases of hemorrhagic choroidal detachment had the same MRI characteristics as melanomas.     

CT of malignant choroidal melanoma—morphology and perfusion characteristics

Summary The computed tomographic morphology of malignant choroidal melanoma and its perfusion characteristics are described. Thirty-three static and serial CT examinations made on 29 patients with choroidal melanoma, three with pseudotumors of the macula and one with choroidal metastasis revealed the choroidal melanoma to be usually a hyperdense, markedly perfused tumor, while the non-contrast, diagnostically undifferentiable pseudotumors and the choroidal metastasis, revealed no significant change in density after the administration of contrast material. Density values or perfusion characteristics of choroidal melanoma that are outside of the normal range are a result of secondary changes within the immediate surroundings of the tumor, such as detachment of the retina, tumor-induced glaucoma, or tumor necrosis.     

眼球脉络膜血管瘤的影像学表现

目的：探讨眼球脉络膜血管瘤的CT、MRI表现及其诊断、鉴别诊断价值。方法：回顾性分析9例经病理（3例）和临床证实（6例）的脉络膜血管瘤。CT扫描6例，MR检查4例，9例均行B超检查，3例作了眼底荧光血管造影。结果：2例CT平扫示眼球后极球壁轻度或新月形增厚，与球壁呈等密度，5例（1例平扫＋增强）增强示眼球后极部高密度梭形或扁平状隆起均匀肿块，瘤体强化明显。与玻璃体比较3例MR T1WI呈高信号，T2WI呈低信号，与视神经、眼外肌相比呈等信号；1例较小肿瘤辅以增强T1WI脂肪抑制技术被清楚显示。渗出性视网膜脱离在T1WI、T2WI上均呈中、高信号；增强T1WI瘤体显著强化，边界清晰，且信号均匀。B超检查8例为实质不均质肿块占位，1例为均质肿块占位，9例均探及视网膜脱离光带。结论：CT＋MRI＋B超检查对脉络膜血管瘤可得到较为全面的影像学诊断资料，MRI在该病的诊断及鉴别诊断中较CT及B超更具敏感性和特异性。     

Uveal melanoma incidentally diagnosed with neuroimaging,a case series of 3 patients

Uveal melanoma is the most common primary intraocular malignancy and can occur in the choroid, the ciliary body, or the iris. It is most often diagnosed based on clinical examination by an ophthalmologist. Nearly all patients present with visual symptoms. Characteristic findings on clinical examination include pigmented or pale choroidal masses with serous retinal detachments and acoustic hollowness seen with ocular ultrasonography. CT and MRI of the orbits are not traditionally utilized for the diagnosis of uveal melanoma. We present 3 cases in which uveal melanoma was an incidental finding on neuroimaging for unrelated conditions in asymptomatic patients. Radiologists should maintain a high suspicion for uveal melanoma when an intraocular mass of greater than 2 mm in thickness is seen on CT or MRI.     

眼球脉络膜转移癌的影像学

描述脉络膜转移癌的CT和MRI表现，对两种检查方法进行评估。材料和方法：回顾性分析经手术病理证实的9例脉络膜转移癌病例，其中7例经CT扫描检查，3例作MRI检查。结果：CT扫描显示眼球后部呈扁平状，均质中高密度肿块，有中度增强。MRI检查为扁平或半月状肿块，T1W呈高于玻璃体中等信号，PDW为高信号，T2W呈低信号。瘤体表面渗出性视网膜脱离在T1W和T2W均呈高信号。结论：CT和MRI对脉络膜转移癌等眼球内病变均可作出定位的影像学诊断。MRI对脉络膜转移癌与脉络膜黑色毒瘤的鉴别、瘤体内结构、与渗出性机网膜脱离的区分以及癌肿侵犯巩膜的情况较CT为优。