眶内炎性假瘤的CT诊断

CT Diagnosis of Orbital Inflammatory Pseudotumor

目的:探讨不同类型眶内炎性假瘤的共性及特异性CT表现,提高眶内炎性假瘤的CT诊断准确率。方法:对42例眶内炎性假瘤的CT资料(均经临床或手术病理证实)进行回顾性分析。结果:42例眶内炎性假瘤按影像学表现分为5种主要类型:I型(肿块型),占9.5%(4/42),CT表现为眶内软组织肿块;Ⅱ型(弥漫型),占11.2%(5/42),CT表现为球后脂肪间隙密度增高,无明显肿块;Ⅲ型(肌炎型),占38%(16/42),CT表现为眼外肌受累增粗,肌腱肥大;IV型(泪腺型),占9.5%(4/42),CT表现为泪腺肿大;V型(混合型),占35.7%(15/42),同时有以上两种或两种以上类型的CT表现。伴有不同程度的鼻副窦炎症17例,占40.5%(17/42),CT显示上颌窦和/或筛窦炎症改变。结论:CT对眶内炎性假瘤的诊断具有重要价值。

Objective To investigate the CT findings of orbital inflammatory pseudotumor in different types and to improve the diagnosis and differential diagnosis of this diseas..Mothods CT findings of orbital inflammatory pseudotumor in 42 cases confirmed by clinic or. Pathology were analysed retrospectively.Results This disease could be categorized five types according to CT findings.（1）mass typein 4 cases （9.5%）, the characteristic CT findings were soft-tissue masses in intmorbit; （2）diffusion type in 5 cases （11.2%） showed retrobulbar fat interspace of high-density without masses;（3）myositis type in 16 cases（38%） showed the enlargement of entire muscles including the tendinous insertion; （4）lacrimal gland type in 4 cases （9.5%）showed enlargement of lacrimal gland on CT;（5）the mixed type in 15 Cases （35.7%） showed hypertrophy of the extra-ocnlar muscles adjacent to mass and high-density of surrounding fat, or hypertrophy of the extra-ocular muscles adjacent to enlarged lacrimal gland.There were in different degree of paranasal sinusit is such as maxillary sinusit is and/or eth- moid sinusit is in 17 cases（40.5%）. Conclusion CT scan is of important role in diagnosing and differential diagnosing orbital in flammatory pseudotumor.