动态增强MRI对眼眶海绵状血管瘤诊断及鉴别诊断的价值

Diagnosis of Orbital Cavernous Hemangioma with Dynamic Contrast-enhanced MRI

目的：运用动态增强技术的MRI，分析眼眶海绵状血管瘤的强化特点，以提高对不同眼眶血管瘤的认识。材料和方法：海绵状血管瘤病例共12例，均为单发病灶，均行MRI，术后均得到病理证实。磁共振系统为Siemens公司Magnetom Vision Plus1.5T。采集线圈为头颅线圈。MR平扫包括：TSE序列的T1WI、T2WI横断面以及T1WI矢状和冠状面扫描。层厚4mm。增强检查，使用高压注射器，以2．0～2．5ml／s的速度于病人桡静脉处注射Gd-DTPA后，立即连续动态扫描7次。以观察造影剂的动态变化状况。结果：海绵状血管瘤有特殊的强化模式，表现为局部点状和小结节状强化，然后逐步向全肿瘤扩展。结论：动态增强的MRI对诊断海绵状血管瘤有重要鉴别诊断的意义。

Purpose： To analyze features of orbital cavernous hemangiomas at dynamic contrast - enhanced MRI and improve the ability of diagnosis and differential diagnosis of the disease. Materials and Methods： 12 consecutive patients with solitary cavernous hemangiomas confirmed by surgery and pathology, underwent scanning with 1.5T MR system. Sagittal, transverse and coronal images, with slice thickness of 4 mm in T1 - weighted, T2 - weighted and turbo- SE sequences, were obtained before administration of Gd- DTPA. The contrast medium was injected through the radial vein with a high - pressure injector at the rate of 2.0 ～ 2.5mL/ s, which was immediately followed by 7 times of continuous dynamic T1 - weighted scans. Results： There is a characteristic dynamic enhancement pattern in cavernous hemangiomas, which started as focal enhancement and then gradually extended to the whole tumor. Conclusions： Dynamic contrast - enhanced MRI is a valuable method in distinguishing orbital cavernous hemangioma from other orbital tumors. A characteristic pattern of enhancement is depicted in spongy hemangioma.