眼眶上壁骨膜下间隙血肿的CT及MRI诊断

CT and MRI Findings of Orbital Superior wall Subperiosteal Hematoma

目的:分析眼眶上壁骨膜下血肿的CT、MRI表现,总结经验,提高诊断水平。方法:回顾分析经临床治疗过程及手术病理证实的10例眼眶骨膜下间隙血肿的临床及CT、MRI表现。结果:CT主要表现为眶上壁下缘梭形或扁平状、弧形类软组织密度灶(其中显示梭形6例,扁平状2例,弧形2例),梭形及扁平状病灶大多为从眶前缘至眶尖,CT值43～67 HU,压迫上直肌及眼球向下移位,眼球均不同程度的突出,增强扫描未见明显强化。低场MRI主要表现是形态与CT一致,亚急性期血肿多呈双高信号(未做增强扫描),高场MRI各期与颅脑硬膜外血肿的演变进程基本一致。结论:CT可以诊断眶壁骨折及对眶壁骨膜下血肿进行初步诊断,结合MRI可以进一步明确血肿的诊断及出血时间。

Objective： TO analyze CT and MRI finding of patients with the orbital superior wall subperiosteal hematoma and to summarize experience and to improve diagnostic level. Methods： CT and MRI data of 9 patients with clinical treatmengt and surgically proved the obital superior wall subperiosteal hematoma. Results： Fusiform,flat or similar to the soft tissue density lesions at the lower edge of orbital superior wall （of which, fusiform in 6 cases, flat shape in 2 cases, arc in 2 cases）, the majority fusiform lesions distributed from orbital leading edge to orbital apex, the CT value were 43 -- 67 HU, oppress Superior rectus muscle and eyeball down- ward shift, eyeball verying degree of prominent, contract did no obvious enhancement mainly low - field MRI and CT were the same shape, Meningioma showed slight hyperdense at sub - acute phase hematoma on both T1 - weighed images and T2 - weighed images（no enhancement）, high - field MRI of the all period and the process ofbrain evolution epidural hematoma is consislent. Conclusion： CT can diagnose orbital fractures and orbital subpe- riosteal hematoma on the initial diagnosis, MRI can make further the correct diagnosis of hematoma and bleeding time.