眼眶孤立性纤维瘤CT及MR征象分析

Analysis of CT and MR imaging features of orbital solitary fibrous tumor

目的探讨眼眶孤立性纤维瘤(SFT)的CT及MRI特点,提高对该病的认识。方法回顾性分析10例经手术病理证实的眼眶SFT的临床、病理、CT及MRI资料。结果10例眼眶SFT均为单发肿块,1例复发恶性肿块形态不规则,其余9例均为良性孤立性边界清晰肿块,病灶最大径15~70 mm;发生于肌锥外间隙4例、肌锥内外间隙2例、肌锥内间隙1例、泪囊区1例、泪腺区1例,弥漫性眶内生长并侵犯筛窦1例。8例行CT平扫,均表现为稍高密度肿块,平均CT值50 Hu,内未见钙化,1例眶壁骨质破坏。9例行MR平扫及增强扫描,与脑皮质相比,T1WI等信号7例,稍低信号2例T2WI低信号7例,等信号1例,稍高信号1例,其内小血管流空影4例,小囊变影2例,囊变坏死1例,增强扫描明显均匀强化7例,明显不均匀强化1例,轻度不均匀强化1例,增强特点为早期快速明显强化,延迟期持续强化。结论眼眶内富血供单发肿块要考虑到SFT的可能,T2WI呈稍低信号,其内见小囊变影或小血管流空影,增强后病灶早期快速明显强化、延迟期持续强化是眼眶SFT的特征性影像学表现。

Objective To discuss the CT and MRI features of orbital solitary fibrous tumor(SFT)and improve the understanding of the disease.Methods The clinical,pathological,CT and MRI data of 10 cases of orbital SFT confirmed by operation and pathology were analyzed retrospectively.Results Ten cases of orbital SFT were single mass;1 case of recurrent malignant mass was irregular in shape,the other 9 cases were benign solitary and well-defined mass,the maximum diameter of the lesion was 15-70 mm;4 cases occurred in extrapyramidal space,2 cases occurred in extrapyramidal space,1 case occurred in intrapyramidal space,1 case occurred in lacrimal sac area,1 case occurred in lacrimal gland area,1 case was with diffuse orbital growth and invasion of ethmoid sinus.CT plain scan of 8 cases showed slightly high density mass,the average CT value was 50 Hu,no calcification was found in the 8 cases,while one case of orbital bone destruction.MR plain scan and enhanced scan in 9 cases,compared with cerebral cortex,there were 7 cases of equal signal on T1WI,2 cases of slightly low signal,7 cases of low signal on T2WI,1 case of equal signal,1 case of slightly high signal,4 cases of empty shadow of internal small blood vessel flow,2 cases of small cystic change,1 case of cystic necrosis,7 cases of significantly uniform enhancement,1 case of significantly uneven enhancement,1 case of slightly uneven enhancement.The enhancement features were rapid and obvious enhancement in the early stage,the delay period continued to enhancement.Conclusion The possibility of SFT should be considered in the single tumor with rich blood supply in orbit.T2WI shows a little low signal,and there is a small cystic change or small vessel flow empty shadow.After enhancement,the early rapid and obvious enhancement and continuous enhancement in the delayed period are the characteristic imaging manifestations of orbital SFT.