摘要
目的探讨眼眶神经鞘瘤的临床诊断和手术治疗方法。方法对1999年8月至2003年12月在北京武警总医院眼眶病研究所治疗的38例眼眶神经鞘瘤患者进行回顾性分析。结果38例中男性15例,女性23例,年龄9-65岁,平均22岁。其中行标准化A/B超检查者37例,CT扫描38例,MRI成像33例。手术入路的选择有外侧开眶(包括改良外侧开眶)26例,内外联合开眶2例,前路开眶4例,内侧开眶2例。其中肿瘤囊内切除21例,肿瘤整体切除15例,部分切除联合术后放射治疗2例。随访时间平均为23个月,手术并发症包括视力丧失1例,上睑下垂2例,眼球运动障碍2例。结论现代影像学检查方法尤其是MRI对眼眶神经鞘瘤的术前定性、定位诊断及对手术入路的选择提供可靠依据,熟练的手术方法和技巧可提高治愈率,减少手术并发症。
Objective To evaluate the diagnosis and surgery of orbital neurilemoma. Methods Thirty-eight patients with pathologically confirmed orbital neurilemomas were analyzed retrospectively. The age of the patients ranged from 9 years to 69 years. Twenty-three patients were female and fifteen were male. Standardized A/B scan was performed in 37 cases. CT scanning was performed in 38 patients with contrast scanning in 15 patients and MR imaging was performed in 33 patients with contrast scanning in 32 patients. Results Neurilemoma was generally low to medium reflective or echo in the ultrasound. Of the 38 cases with orbital neurilemomas, location of tumors was superior of the orbit in 17 cases ; lateral and inferior in 19 cases and medial in 2 cases. Shape of the tumors was elongate or round-like 26 cases, leaf-like and dumbbell 12 cases. CT scanning showed soft tissue high density mass in 32 cases, 6 cases were heterogeneity ( for cystoid change). MR imaging in 33 patients displayed a identical T1 and a long T2 signal intensity weighted images in 4 cases ; identical T1 and T2 mixed signal ( short, identical and long signal) in 28 cases ; identical T1 and T2 in 1 cases. After Gd-DTPA enhancement in 32 cases, heterogeneity enhancement of the mass was seen in 28 cases, marked enhancement 4 cases. Four cases in all cases was found orbital-cranial communicate mass. Surgical approach was lateral orbitotomy in 26 cases, combined lateral and medial orbitotomy in 2 cases, anterior orbitotomy 4 cases and medial orbitotomy in 2 cases. Conclusions Modem medical imaging, especial MR imaging can demonstrate the site, configuration, and characteristics of the tumors and contribute to the diagnosis and treatment. Skill of surgery can improve the rate of success and decrease the complications.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2006年第7期585-589,共5页
Chinese Journal of Ophthalmology
关键词
眶肿瘤
神经鞘瘤
体层摄影术
X线计算机
磁共振成像
眼外科手术
Orbital neoplasma
Neurilemmoma
Tomography, X-ray computed
Magnetic resonance imaging
Ophthalmologic surgical procedures