多层螺旋CT三期强化扫描和MRI增强扫描诊断眼眶海绵状血管瘤的价值分析

目的分析多层螺旋CT(MSCT)三期强化扫描和MRI增强扫描诊断眼眶海绵状血管瘤的价值。方法选取2014年5月至2018年8月我院诊治的85例疑似眼眶海绵状血管瘤患者(其中40例经手术病理证实为眼眶海绵状血管瘤)为研究对象,均接受MSCT平扫、MSCT三期强化扫描、MRI平扫、MRI增强扫描,分析其影像特点,并评估MSCT与MRI对眼眶海绵状血管瘤的诊断价值。结果 MSCT平扫上肿瘤与眼外肌密度相似,呈圆形或类圆形,轮廓光滑,见分叶,点状、小圆形高密度钙化,强化后65例呈不均质渐进样强化,14例呈持续性强化,6例增强扫描无明显强化;MRI平扫发现T1WI结节状低信号,轮廓清晰,点状高信号,T2WI高信号影,DWI呈等或偏低信号,ADC图呈低信号,增强扫描呈显著填充式强化;MSCT三期强化扫描诊断眼眶海绵状血管瘤的灵敏度高于MRI增强扫描,特异度、准确度低于MRI增强扫描,而两者联合诊断的灵敏度、特异度、准确度进一步提高,分别为95.00%、88.89%、91.76%。结论 MSCT三期强化扫描及MRI增强扫描诊断眼眶海绵状血管瘤均有一定价值,前者诊断准确率高,而联合诊断的效能更好,值得在临床推广实践。

Value of Multislice Spiral CT Three-phase Enhanced Scan and MRI Enhanced Scan in the Diagnosis of Orbital Cavernous Hemangioma

Objective To analyze the value of multislice spiral computed tomography(MSCT) three-stage enhanced scan and MRI enhanced scan in the diagnosis of orbital cavernous hemangioma. Methods 85 patients with suspected orbital cavernous hemangioma(40 patients with orbital cavernous hemangioma confirmed by surgical pathology) in the hospital from May 2014 to August 2018 were chosen. All patients underwent MSCT plain scan and MSCT three-stage enhanced scan, MRI plain scan, and MRI enhanced scan, the imaging characteristics were analyzed, the diagnostic value of MSCT and MRI for orbital cavernous hemangioma was evaluated. Results On the plain scan of MSCT, the tumor and the extraocular muscles were similar in density. They were round or analogously round with a smooth outline, there were lobulated, punctate, small round and high-density calcification. After strengthening, there were 65 cases with inhomogeneous progressive enhancement, 14 cases with continuous enhancement, 6 cases without obvious enhancement in enhanced scan. MRI plain scan found T1 WI with tuberculous low signal, clear outline, punctate high signal and T2 WI with high signal shadow, DWI showed equal or low signal, ADC image showed low signal, enhanced scan showed significant filling enhancement. The sensitivity in diagnosis of orbital cavernous hemangioma by MSCT three-phase enhanced scan was higher than that by MRI enhanced scan, while the specificity and accuracy were lower than those by MRI enhanced scan, the sensitivity, specificity and accuracy by the combined diagnosis of the two were further improved with 95.00%, 88.89% and 91.76% respectively. Conclusion Both MSCT three-phase enhanced scan and MRI enhanced scan have certain value in the diagnosis of orbital cavernous hemangioma. The former has a higher diagnostic accuracy, the combined diagnosis of the two has better efficiency.