眶颅沟通性肿瘤的MRI诊断价值

目的:探讨MRI对眶颅沟通性肿瘤性病变的显示能力及其临床价值。方法:45例患者,男20例,女25例。发病年龄4～66岁,平均41岁。均经手术及病理证实。所有病例均行MRI普通扫描,其中15例行强化扫描。结果:本组资料MRI显示眶颅沟通性肿瘤常有4个沟通渠道。其中18例经视神经管沟通,包括视神经胶质瘤8例,视神经鞘脑膜瘤8例,视网膜母细胞瘤2例,侵犯视交叉及海绵窦。通过眶上裂沟通14例,神经鞘瘤6例,视神经鞘脑膜瘤6例,炎性假瘤2例,侵犯同侧海绵窦。通过眶下裂沟通5例,神经鞘瘤5例,侵犯同侧海绵窦。经过眶壁骨质缺损与颅内沟通8例,有皮样囊肿2例,泪腺腺样囊性癌4例,蝶骨脊脑膜瘤2例。结论:MRI平扫及增强扫描能明确显示眶颅沟通性肿瘤的沟通路径,为临床治疗提供重要和直接的依据。

Evaluation of MRI in diagnosis of orbito-cranial communicating tumors

Objective: To discuss the MRI findings and features of orbito-cranial communicating tumors,and evaluate the clinical role of MRI.Methods: We studied fourty-five cases of orbito-cranial communicating tumors,including male 15 and famale 30.All of the cases were confirmed by operation and pathology.The patient's age ranged from 4 to 66 years,and the average-age was 41.Routine MRI was performed in all 45 cases,and Gd-DTPA enhancement MRI was completed in 15 cases.Results: The MRI shown there were four familiar communicating passages in orbito-cranial communicating tumors.The comumunicating passage between the orbital cavity and the cranial cavity through optic canal was 18 cases,including 8 optic gliomas,8 meningiomas of optic nerve sheath and 2 retinoblastomas,and some lesions were involved optic chiasm and sinus cavernosus.The comumunicating through superior orbital fissure was 14 cases,including 6 neurilemmomas,6 meningiomas of optic nerve sheath,and 2 inflammatory pseudotumors,and in some cases the same side of sinus cavernosus was involved.The comumunicating via inferior orbital fissure was 5 cases,all of them were neurilemmomas,and involved the same side sinus cavernosus.In addition,the communicating passage of bone walls defect caused by tumor was 8 cases including 2 dermoid cyst,4 adenoid cystic carcinomas of lacrimal gland,and 2 meningioma of sphenoid bone.Conclusion: Routine and enhancement MRI examinations could definitely display communicating passages of orbito-cranial communicating tumors and the imaging changes of the lesions,which could supply the important and direct evidence for the clinical diagnosis,and provide valuable information for clinical treatment.