眼眶上壁骨膜下间隙血肿的CT及MRI诊断

目的:分析眼眶上壁骨膜下血肿的CT、MRI表现,总结经验,提高诊断水平.方法:回顾分析经临床治疗过程及手术病理证实的10例眼眶骨膜下间隙血肿的临床及CT、MRI表现.结果:CT主要表现为眶上壁下缘梭形或扁平状、弧形类软组织密度灶(其中显示梭形6例,扁平状2例,弧形2例),梭形及扁平状病灶大多为从眶前缘至眶尖,CT值43～67 HU,压迫上直肌及眼球向下移位,眼球均不同程度的突出,增强扫描未见明显强化.低场MRI主要表现是形态与CT一致,亚急性期血肿多呈双高信号(未做增强扫描),高场MRI各期与颅脑硬膜外血肿的演变进程基本一致.结论:CT可以诊断眶壁骨折及对眶壁骨膜下血肿进行初步诊断,结合MRI可以进一步明确血肿的诊断及出血时间.

CT and MRI Findings of Orbital Superior wall Subperiosteal Hematoma

Objective:TO analyze CT and MRI finding of patients with the orbital superior wall subperiosteal hematoma and to summarize experience and to improve diagnostic level.Methods:CT and MRI data of 9 patients with clinical treatmengt and surgically proved the obital superior wall subperiosteal hematoma.Results:Fusiform、flat or similar to the soft tissue density lesions at the lower edge of orbital superior wall(of which,fusiform in 6 cases,flat shape in 2 cases,arc in 2 cases),the majority fusiform lesions distributed from orbital leading edge to orbital apex,the CT value were 43～67 HU,oppress Superior rectus muscle and eyeball downward shift,eyeball verying degree of prominent,contract did no obvious enhancement mainly low-field MRI and CT were the same shape,Meningioma showed slight hyperdense at sub-acute phase hematoma on both T1-weighed images and T2-weighed images(no enhancement),high-field MRI of the all period and the process of brain evolution epidural hematoma is consistent.Conclusion: CT can diagnose orbital fractures and orbital subperiosteal hematoma on the initial diagnosis,MRI can make further the correct diagnosis of hematoma and bleeding time.