特发性眶炎症与眼眶神经鞘瘤CT、MRI图像表现及鉴别诊断

F eatures of CT and MRI Images of Idiopathic Orbital Inflammation and Neurilemmoma and Their Differential Diagnosis Value

目的分析特发性眶炎症与眼眶神经鞘瘤CT、MRI图像表现及鉴别诊断价值。方法回顾性分析本院2018年7月至2019年10月收治的特发性眶炎症和眼眶神经鞘瘤患者的临床资料,比较MRI检查和MSCT检查对特发性眶炎症和眼眶神经鞘瘤定性、定位诊断符合率,并分析两者影像学表现。结果 40例患者MSCT、MRI检查对特发性眶炎症与眼眶神经鞘瘤的定性、定位诊断准确率比较差异无统计学意义(P>0.05)。特发性眶炎症3例呈椭圆形,2例呈不规则形。泪腺型5例呈椭圆形,4例呈扁平状。眼眶神经鞘瘤21例位于肌椎内,26例位于肌椎外。3例视神经受压移位,19例肿瘤内可见囊变和出血,未见包绕视神经生长。MRI可见4例出现肿瘤颅内蔓延。结论 MSCT检查和MRI检查均可有效显示特发性眶炎症与眼眶神经鞘瘤的影像学特点,但MRI检查鉴别诊断的能力要优于MSCT,具有较高的应用价值。

Objective To analyze the features of CT and MRI images of idiopathic orbital inflammation and neurilemmoma and their differential diagnosis value.Methods The clinical data of patients with idiopathic orbital inflammation and neurilemmoma admitted from July 2018 to October 2019 in our hospital were retrospectively analyzed.The accuracy of MRI and MsCT examination for qualitative and localization diagnosis of idiopathic orbital inflammation and neurilemmoma were compared,and the imaging features were analyzed.Results There were no significant differences in the accuracy of qualitative and localization diagnosis between MsCT and MRI for idiopathic orbital inflammation and neurilemmoma in 40 patients(P>0.05).The idiopathic orbital inflammation of 3 cases were oval and 2 cases were irregular.Five cases with dycryoadenitis idiopathic orbital inflammation were oval and 4 cases were flat.Neurilemmoma of 21 cases were located inside the vertebral body and 26 cases were located outside the vertebral body.In 3 cases,the optic nerve was compressed and displaced.In 19 cases,cystic changes and hemorrhage were seen in the tumor,not along the optic nerve.MRI showed intracranial spread of the tumor in 4 cases.Conclusion Both MsCT and MRI can effectively show the imaging features of idiopathic sputum inflammation and orbital schwannomas,but the ability of MRI to differential diagnosis is superior to that of MsCT,which has high application value.