视神经胶质瘤32例临床分析

Clinical analysis of optic nerve glioma

目的探讨总结视神经胶质瘤的临床表现、影像学特征、诊断及治疗原则。方法回顾性分析1995～2010年间在天津医科大学第二医院眼科诊治的经病理组织学证实的视神经胶质瘤32例，将其临床资料及B型超声、彩色多普勒超声、CT、MRI进行分析。结果视神经胶质瘤多发于10岁以内的儿童，占72％（23，32），视力减退或丧失、眼球突出以及视乳头水肿或萎缩为视神经胶质瘤的典型临床表现。CT可显示视神经不同形态增粗，部分可见视神经管、眶上裂扩大；MRI可更好地观察到肿瘤自眼眶向视神经管内及颅内蔓延情况。治疗以手术切除为主。结论视神经胶质瘤临床表现多样，影像学检查有助于诊断和鉴别诊断，治疗应根据患者具体情况综合制定。

Objective To explore and summarize manifestation, iconographic characterizations, di-agnosis and treatment principles of optic nerve glioma. Methods Retrospectively reviewed the clini-cal features and imaging features including B-scan ultrasonography, Color Doppler ultrasound （CDI）, computed tomography （CT） and magnetic resonance imaging （MRI） of 32 patients with pathological-ly confirmed optic nerve glioma, who were treated in our department from 1995 to 2010. Results Optic nerve glioma was common within 10 years old children. Visual loss, proptosis, and optic nerve swelling or atrophy was the typical clinical characters. CT could show optic nerve enlarged with various morphology, and the enlarged optic canal and superior orbital fissure was also visible in some case. MRI could observe the lesions in the optic canal and cranium better. Surgical exci-sion of the tumor was the main treatment method. Conclusions The clinical of optic nerve glioma are various. Iconographical examinations are very helpful for diagnosis and differential diagnosis. Therapeutic schedule should be synthetically formulated with patient＇s specific conditions.