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。

Imaging investigation of orbital neurilemoma

ObjectiveOrbital neurilemoma is common benign tumor in ophthalmology,and it is causing a increasing concern of ophthalmologist because it is difficult to make a definite diagnosis prior to operation.In present experiment,we evaluated the role of tomography(CT) and magnetic resonance imaging (MR) in the diagnosis of orbital neurilemoma.MethodsCT and MR imaging of 42 patients with pathologically confirmed orbital neurilemomas were analyzed retrospectively.CT scanning was performed in all 42 patients and contrast scanning in 15 patients of them,and MR imaging was performed in 37 patients and contrast scanning in 35 patients of them.ResultsOf the 42 cases with orbital neurilemomas,tumors was located at superior orbit in 20 cases,lateral in 9 cases,inferior 11 cases and medial in 2 cases.Tumors were elongate-shape in 19 cases,round-like 8 cases,leaf-like 9 cases and dumb-bell 6 cases.CT scanning showed iso-density mass in 28 cases and heterogeneity in 14 cases,and 5 cases of later showed cystoid-like change.MR imaging displayed a identical T1 and a long T2 signal intensity weighted images in 4 cases,identical T1 and T2 mixing signal in 29 cases,identical T1 and T2 in 4 cases.After Gd-DTPA enhancement in 35 cases,heterogeneity enhancement of the mass was seen in 31 cases and obvious enhancement in 4 cases.Orbital-cranial communicating mass was found in 5 cases in all cases tested.ConclusionCT and MR imaging can determine the site,configuration,and characteristics of neurilemoma,and these imaging methods offer better evidence for diagnosis and treatment of tumor.MR imaging is superior to CT in the diagnosis of orbital neurilemoma.