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目的分析4例眼眶血管内皮瘤的影像表现,并复习相关文献帮助了解其表现以及诊断与鉴别诊断要点。方法回顾性分析4例手术病理证实的眼眶血管内皮瘤的 CT 和 MRI 表现及MR 动态增强扫描的特点。结果 3例位于眼眶肌锥外间隙的前颞上象限,1例位于眼眶肌锥外间隙的前鼻下象限。3例呈椭圆形,1例形态不规则。4例 CT 均呈均匀的等密度,3例邻近的骨质呈受压改变,1例没有骨质改变。4例在 MRI 上均呈不均匀的略长 T_1、长 T_2信号影,可见信号流空影,增强后早期呈明显强化,动态增强扫描的时间信号强度曲线表现为 D 型。结论眼眶血管内皮瘤主要是位于肌锥外间隙的有血管流空影和早期明显强化的富血管性肿瘤,MRI 是显示和诊断眼眶血管内皮瘤的最佳方法。
Objective To analyze the imaging manifestations of 4 cases of orbital hemangioendothelioma and to review the relevant literature to help understand its performance as well as the diagnostic and differential diagnosis points. Methods The CT and MRI findings of 4 cases of orbital hemangioendothelioma confirmed by surgery and pathology were retrospectively analyzed and the features of MR dynamic contrast-enhanced scanning were analyzed. Results Three cases were located in the anterior superior temporal quadrant of the extraorbital space of the orbital muscle and the anterior and inferior nasal quadrant of the extraorbital space in the orbital muscle. 3 cases were oval, 1 case of irregular shape. Four cases of CT were uniform density, 3 cases of adjacent bone was pressure changes, 1 case of no bone change. All of the 4 cases showed a slightly longer T_1 and longer T_2 signal shadow on MRI, and the signal flow was spatially sharpened, which was obviously enhanced in the early stage of enhancement. The time signal intensity curve of dynamic enhanced scan showed D type. CONCLUSIONS: Orbital hemangioendothelioma is mainly located in the outer space of the muscular cone with vascular flow empty shadow and early obviously enhanced vascular tumor. MRI is the best method to show and diagnose orbital vascular endothelioma.