眼眶海绵状血管瘤的影像学表现及其意义

Imaging findings of orbital cavernous hemangioma and their significance

目的研究眼眶海绵状血管瘤的ＣＴ和ＭＲＩ征象，并着重探讨海绵状血管瘤的特异性征象即“渐进性强化”，及其在诊断和鉴别诊断海绵状血管瘤中的价值。方法对经手术病理证实的眼眶海绵状血管瘤５８例进行回顾性分析。所有病例均行Ｂ超检查，其中ＣＴ检查４８例，ＣＴ增强扫描４３例，动态增强扫描１０例；ＭＲＩ检查２７例，动态增强扫描２４例。结果ＣＴ增强后３６例（８３．７％）显示不同程度的片状强化，１０例ＣＴ动态增强扫描，７例（７０．０％）呈“渐进性强化”，３例（３０．０％）未显示明显强化。２４例行ＭＲ动态增强扫描，２例（８．３％）直径在１．５ｃｍ以下的海绵状血管瘤未显示该征象，２２例（９１．７％）直径在１．５ｃｍ以上的海绵状血管瘤显示该征象。结论“渐进性强化”是诊断海绵状血管瘤的特异性征象；ＭＲＩ显示该征象优于ＣＴ。

Objective To study the CT and MRI findings of orbital cavernous hemangioma with emphasis on its specific sign progressive enhancement. Methods Fiftyeight cases with orbital cavernous hemangioma were proved by surgery and pathology. Btype ultrasound was performed in all cases, CT in 48 cases,and MRI in 27 cases. Dynamic contrast CT was performed in 10 cases and sequential Gdenhanced MRI in 24 cases. Results CT serial dynamic enhancement showed progressive enhancement in 7 cases(70%) and no enhancement in 3 cases(30%).On MR T1WI, the tumors were isointense or slightly hypointense with respect to muscle and on T2WI the tumors were homogeneously hyperintense with respect to muscle in all 27 cases.On sequential Gdenhanced MRI, progressive and homogeneous filling of the mass was seen in 22 cases with cavernous hemangioma. Conclusions Progressive enhancement is a pathognomonic sign of cavernous hemangioma which differentiates it from other tumors. MRI is superior to CT in showing progressive enhancement .