眼眶神经源性肿瘤的比较影像学研究

A comparative study on methods of imaging over orbital neurogenic tumors

目的探讨超声、CT及MRI对胶质瘤、脑膜瘤、神经鞘瘤、神经纤维瘤等四种主要眼眶神经源性肿瘤的诊断价值。方法收集中山眼科中心1999年1月～2005年6月经手术治疗,具有完整病理资料的眼眶神经源性肿瘤110例,回顾分析超声、CT、MRI检查的结果并与病理作对照,比较定性及定位诊断率。结果超声均未作出定性诊断,故未能作出比较分析。临床诊断四种疾病的的正确率分别是胶质瘤78.6%、脑膜瘤58.8%、神经鞘瘤42.9%、神经纤维瘤96.3%,CT诊断分别是55.5%、92.9%、71.4%、80.0%,MRI诊断分别是83.3%、100%、100%、100%。定性诊断率临床为65%,CT为77.25%,MRI为95%。定位诊断率超声为70%,CT为77.25%,MRI为90%。结论CT和MRI对肿瘤定位准确,定性诊断准确性优于眼科临床和超声。

Objective To probe value of B-type ultrasound, CT and MRI in diagnosis of four major orbital neurogenic tumors including glioma, optic nerve sheath meningioma, neurilem- moma and neurofibroma. Methods 110 patients with orbital neurogenic tumors underwent operation in Zhongshan Ophthalmic Center during January 1999-June 2005. The patients had complete pathological data, which were referred to to evaluate locating and identifying capacity of imaging methods including B ultrasound, CT and MRI. Results B ultrasound failed to make any qualitative diagnosis so it was not further studied. The correctness rate of clinical diagnosis for optic nerve glioma, optic nerve sheath meningioma, neurilemmoma and neurofibroma was 96.3%, 78.6%, 58.8% and 42.9% respectively; correctness rate of CT was 55.5%, 92.9%, 71.4%, 80.0% respectively; and correctness rate of MRI was 83.3%, 100%, 100%, 100% respectively. The identifi- cation correctness rate of clinical diagnosis, CT diagnosis and MRI diagnosis was 65%, 77.25% and 95% respectively, and locating correctness rate of clinical diagnosis, CT diagnosis and MRI diagnosis was 70%, 77.25% and 90% respectively. Conclusion CT and MRI are better for locating and identifying ophthalmic tumors than clinical data and ultrasound method.