眼眶神经源性肿瘤45例CT与MRI表现

The character of CT, MRI findings of 45 orbital neurogenic tumors

目的 探讨眼眶神经源性肿瘤的CT、MRI表现.方法 对2009年9月至2014年10月在天津市第一中心医院眼科收集45例眼眶神经源性肿瘤的临床资料和影像学结果,回顾性分析其CT、MRI特点.结果 45例眼眶神经源性肿瘤中,周围神经源性肿瘤24例,以神经鞘瘤多见,CT表现为长椭圆形或条索状占位影,部分可见典型的“小尾巴”征;MRI检查显示肿瘤在T1WI上为等信号,在T2WI上为低中高混杂信号,呈不均匀强化.中枢神经源性肿瘤18例,以脑膜瘤多见,可起源于眶骨骨膜、视神经鞘及异位脑膜,其各自CT表现较典型;MRI检查显示肿瘤在T1WI上为等信号或等信号混杂低信号,在T2WI上为高信号或中等偏高信号,增强扫描后可见“硬膜尾征”;3例组织来源不肯定,分别为嗅神经母细胞瘤2例、神经节细胞瘤1例,其影像学表现均存在各自特点.结论 神经源性肿瘤在眼眶肿瘤中较常见,以脑膜瘤及神经鞘瘤多见.CT和MRI能显示肿瘤的位置、形状及其内部特点,对明确临床诊断及制定治疗方案有着重要的临床意义。

Objective To investigate the CT,MRI findings of orbital neurogenic tumors.Methods The clinical materials and imaging of 45 patients with orbital neurogenic tumors were collected,and retrospectively analyzed the characteristic of CT,and MRI.Results Forty-five cases of the orbital neurogenic tumors,mainly peripheral neurogenic tumors 24 cases,and the neurilemmoma was the most common.In the CT-scan,the oval or cords shaped shadow,visible characteristic ＂tail＂-like shadow,identical signal in T1WI and mixed signal in T2WI could be seen in MR imaging,showed heterogeneous enhancement.Central neurogenic tumors 18 cases,including meningioma （16 cases）,could originate from the orbital bone periosteum,optic nerve sheath and ectopic meninx,their CT manifestations were typical,identical signal in T1WI and high signal in T2WI could be seen in MRI imaging,enhanced scanning visible ＂dural tail sign＂.Three cases of the tissue of origin were not certain,respectively in 2 patients with olfactory neuroblastoma,1 case of paraganglioma,their imaging had respective characteristics.Conclusions Neurogenic tumors are common in orbital tumor,in addition meningioma and schwannoma have a large proportion.CT and MRI can show the location,shape and internal characteristics of the tumor,these imaging method has significant value in the diagnosis and treatment.