Objective: To discuss the performance of clinical and type-B ultrasonic, the characteristic of magnetic resonance imaging (MRI) in orbit isolated nerve fibroma and to discuss the correspondence between the signal strength of MRI and histology combined with tissue section. Methods: The performance of clinical and type-B ultrasonic, the characteristic of MRI and the pathological results of 8 cases with orbit isolated nerve fibroma were described. Results: The major clinical manifestation of the patients with orbit isolated nerve fibroma was progressive proptosis. It could be showed that the shape of eyeball behind was circular or approximate circular, the bandary was clear, low or moderate echo space occupying lesion and moderate sound attenuation through type-B ultrasonic; It could be seen the placeholder of abnormal signals of circular or approximate circular and clear bandary in the eyepit. Compared with vitreous, MRI showed slightly low or moderate signals on T,WI, mixed slightly low or high signals on T2WI in 6 cases, but slightly low signals on both T1WI and T2WI in 2 cases, and slightly enhanced on GD-T1 WI in 8 cases. The light microscope apperance of orbit isolated nerve fibroma: It could be seen that, in 6 cases, there were moderate or a mass of fusiform tumor cells, the hyalomitome was acidophilous, cell nucleus was fusiform with cusp in both ends, wavy and hyperchromatic, the cell was arranged in fasciculate, and many collagen fibers and a sprinkle mucus base were invovled in interstitial; in 2 cases, the tumor cells were abundant, growing well, arranged in fences and mitotic figures could be seen, and a lot of collagen fibers were invovled in intercellular substance. Conclusion: The clinical manifestation and imaging examination of orbit isolated nerve fibroma and orbit benign tumors can be very confusing. The clinical diagnose must depend on the pathological examination. There may be some relationship between MRI signals and pathological construction of orbit isolated nerve fibroma.%目的:探讨眼眶孤立性神经纤维瘤的临床及B型超声表现、MRI特点,并结合病理切片讨论MRI信号强弱与组织学的对应关系.方法:对8例患者的临床表现、B型超声、MRI特点及病理结果进行描述.结果:眼眶孤立性神经纤维瘤患者主要临床表现为眼球渐进性突出;B型超声显示眼球后圆形或类圆形,边界清楚,低或中等回声占位性病变,声衰减中等;MRI检查可见眼眶内边界清楚的圆形或类圆形异常信号占位,与玻璃体比较,6例T1加权像(T1WI)呈稍低或中等信号,T2加权像(T2WI)为稍低和较高信号混杂,2例T1WI和T2WI均呈中低信号.8例增强均有轻到中度强化.肿瘤光镜下6例表现为中到大量梭形肿瘤细胞,胞浆嗜酸性,胞核呈梭形,两端较尖,染色深,呈波浪状,细胞呈束状排列,间质含较多胶原纤维和少量黏液样基质.2例肿瘤细胞丰富,生长活跃,呈栅栏状排列,内可见核分裂像,间质含有大量胶原纤维.结论:眼眶孤立性神经纤维瘤其临床表现和影像学检查容易与眼眶内良性肿瘤混淆,确诊必须依靠病理检查.肿瘤的病理构成与MRI信号有一定的关系.
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