115例眶内肿瘤CT分析

Analysis of CT features of intraorbital neoplasm in 115 cases

目的:回顾性探讨115例眶内肿瘤CT影像学特点,为临床诊断和治疗提供影像学依据。方法:搜集115例眶内肿瘤患者的临床资料和CT影像学资料进行回顾性分析。115例中经手术及穿刺活检病理证实为眶内海绵状血管瘤者33例、炎性假瘤30例、皮样囊肿12例、多形性腺瘤11例、腺样囊性癌6例、脑膜瘤6例、神经鞘瘤6例、神经纤维瘤2例、眶内转移瘤3例(包括肺癌2例、结肠癌1例)、继发性肿瘤1例(视神经母细胞瘤眶内浸润)、横纹肌肉瘤、脂肪瘤、淋巴瘤、原发性眶内黑色素瘤及恶性血管内皮细胞瘤各1例。结果:良性肿瘤CT表现为大多数呈边缘清楚圆形、椭圆形肿块,与周围组织分界清楚,压迫周围组织造成移位,眶壁骨质无破坏。恶性肿瘤大多数呈边界不清,形态不规则肿块,与周围组织分界不清,可压迫或包绕周围组织,眶壁骨质破坏。CT定位诊断率100%,定性诊断率76.8%(88115),良性肿瘤定性诊断率达80.1%(81101),恶性肿瘤定性诊断率50%(714)。结论:眶内肿瘤具有一定的CT影像学特征,根据CT影像学特点及临床表现可对大多数眶内肿瘤作出定性诊断。

Objective： To analyse the CT features of intraorbital neoplasm in 115 eases in order to provide the imaging basis for clinical diagnosis and treatment. Methods： To analyse the clinical and CT data of 115 eases with intraorbitai neoplasm, which include cavernous hemangioma（33 eases）, inflammatory pseudotumor（30 eases）, dermoid cyst（12 eases）, pleomorphic adenoma（11 eases）, adenoid cystic careinoma（6 cases）, meningioma（6 eases）, schwannoma（6 eases）, neurofibroma（2 cases）, intraorbital metastasis（lung cancer 2 eases, colon cancer 1 ease）, secondary tumor（retinoblastoma 1 ease）, rhabdomyosarcoma（1 ease）, lipoma（1 ease）, lymphoma（1 ease）, primary intraorbital melanoma（1 ease） and malignant hemangioendothelioma（1 ease）. Results： Most benign neoplasms show round or oval mass with clear border and seldom involve other intraorbital structures while malignant neoplasms show irregular mass with unclear margin and extensive infiltration, osseous damage with invasion and spread toward peripheral tissues. The accuracy of localizing diagnosis was 100%, and 76.8% for specific diagnosis, of which the benign neoplasm was 80.1% and the malignant neoplasm 50%. Conclusion： Each kind of intraorbital neoplasm has its own characteristic CT findings. According to CT findings and clinical presentations, most intraorbital neoplasms can be diagnosed.