眼眶孤立性纤维瘤12例临床影像学分析

Clinical imaging analysis of 12 cases of orbital solitary fibrous tumor

目的:探讨眼眶孤立性纤维瘤(SFT)的彩色多普勒超声及磁共振成像(MRI)特点。方法:回顾性病例研究。收集2013-04/2018-08天津医科大学眼科医院收治的12例眼眶SFT患者的临床资料,均行彩色多普勒超声和MRI平扫、增强及动态增强检查,分析其临床影像学特点。结果:纳入的12例患者中男7例,女5例,病程3mo^20a(平均3.2±5.2a),6例为首次发病,6例为复发病例;均为单眼发病,其中左眶8例,右眶4例。肿瘤位于眼球后肌锥间隙内5例,肌锥间隙外3例,跨肌锥间隙内、外4例;肿瘤形状呈卵形9例,不规则形3例,边界均清晰。超声表现为低回声10例,不均匀回声2例;12例彩色多普勒血流显像(CDFI)均可见血流信号,阻力指数(RI)平均值0.70,PW均测得动脉频谱。MRI表现在T1WI均呈等信号;T2WI呈低信号5例,等信号3例,中高信号4例,内部信号均匀9例,不均匀3例;增强后12例均呈显著强化,10例均匀强化,2例不均匀强化。动态增强扫描的时间-信号强度曲线(TIC)7例为速升平台型,5例为速升速降型。结论:眼眶SFT在彩超显示低回声、富血供的实体瘤,MRI提示T1WI呈等信号,T2WI信号混杂,增强后显著强化,动态增强TIC曲线以速升型为主的特征性表现对诊断具有重要意义。

AIM:To investigate the characteristics of color Doppler sonography and MRI in orbital solitary fibrous tumor(SFT).METHODS:It was a retrospective case series study.A total of 12 cases of orbital solitary fibrous tumors were recruited from April 2013 to August 2018 in Tianjin Medical University Eye Hospital.Color Doppler sonography and MRI plain scan and DCE-MRI were applied in all cases.RESULTS:Of 12 cases,7 cases were males and 5 were females,with the duration of symptoms ranged from 3mo-20y,with an average course of 3.2y;6 cases were the primary cases and 6 cases were relapse cases.All lesions involved one side of the orbit,of which 8 cases were in the left orbit and 4 in the right.Of 12 cases,there were 5 tumors in intraconal space,3 in the extraconal space,and 4 in intra and extraconal space.Well-circumscribed lesions showed oval shape in 9 cases and the left 3 were irregular.12 cases showed hypoechoic and 2 cases heterogeneous signal on color Doppler sonography;All cases had flow signals on CDFI,and showed arterial spectrum on PW.On T1WI,all lesions demonstrated isointense.On T2WI,5 lesions showed hypointense,3 lesions showed isointense and 4 lesions slight hyperintense,of which 3 lesions showed heterogeneous signal.After contrast enhancement,all cases demonstrated markedly enhancement,with homogeneous enhancement in 10 cases and heterogeneous enhancement in 2 cases.The time-intensity curves(TIC)of 7 cases exhibited a rapid washout pattern,and 5 cases a rapid plateau pattern on DCE-MRI.CONCLUSION:Color Doppler sonography features of orbital SFT include hypoechoic and flow signals.Heterogeneous signals on T2WI,marked enhancement,and a rapidly enhancing and slow washout pattern TIC on DCE-MRI are the typical MRI features of orbital SFT.