单侧眼球突出的CT诊断及病因分析

Computer tomography findings and causes of unilateral exophthalmos

目的探讨致单侧眼球突出的常见病因及CT征象。方法回顾性分析267例突眼症患者的CT表现,其中134例加行CT增强扫描。突眼病因中41例经手术及病理活检证实,68例经穿刺及病理活检证实,158例具有典型病史并经临床检验、治疗或随访结果证实。结果 267例突眼症患者中,病灶位于球内10例、球外眶内230例及眶周27例。本组研究中引起单侧眼球突出最多见的病因眼眶特发性炎症(67例)、泪腺多形性腺瘤或癌(44例)、海绵状血管瘤(22例)、颈内动脉-海绵窦瘘(20例)、静脉曲张(18例)等。其中CT主要表现有眼球突出,眼球内或周围肿块,眼肌增粗等;增强扫描,病变有不同程度的强化,坏死囊变区无强化。结论 CT检查可以对单侧眼球突出作出病因诊断,而且可以显示病变的来源、眼眶内结构的改变及范围。

Objective To evaluate the common cause of unilateral exopbthalmos and CT findings. Methods The CT manifestations of 267 cases of unilateral exophthalmos were reviewed. 41cases were confirmed by surgery and pathology. 68 cases were confirmed by biopsy. Diagnosis was made in 158 cases on the basis of typical history, laboratory findings and response to treatment. Results The lesions were intraocular （10 cases）, intraortrital （230） and periorbital lesions （27）. The most common causes of unilateral exophthalmos included inflammatory pseudotumor （67 cases）, pleomorphic adenoma or carcinoma of lachrymal gland （44）, cavernous angioma （22）, carotid cavernous fistula （20） and varices （18）. The CT appearances were exophthalmos, intraocular or periorbital tumor, extraocular muscle hypertrophy. The contrast enhancement was variable without enhancement in necrotic areas. Conclusion CT scan is valuable for diagnosis and displaying the structural change of unilateral exophthalmos.