Objective To study the characteristic of the clinical and image features of distensible orbital venous malformations ( DOVM ).Methods It was a retrospective case series study.Clinical features and imaging findings,including B ultrasonography,CDFI,MRI,CT imaging of 43 patients with DOVM were reviewed in Shanghai Changzheng Hospital affiliated to Secondary Military Medical University.Results Forty-three patients (24 women and 19 men),whose ages range from 5 to 71 years old,showed clinical or radiological evidence of distensiblity.The mean age was 32 years.Location of the lesion within the orbit was variable,9 patients with superficial lesions,and 19 patients with deep lesions. Twelve patients were classified as combined lesions.3 patients with extraorbital venous malformations were classified as complex lesions.Twenty of 43 patients with DOVM were initially seen with proptosis or pain increasing with the head in a dependent position. Eight patients presented with a sudden onset of proptosis and pain secondary to thrombosis or hemorrhage.B ultrasonography showed an intermittently anechoic lesion that exhibits intrinsic flow during the Valsalva maneuver.Color Doppler imaging might demonstrate a reversal of flow toward the transducer during the Valsalva maneuver.Thirty-five of 43 cases with axial CT images showed a normal appearance or only mild enlargement of the involved veins,but coronal CT images could clearly demonstrate the lesion distensibility. Eight cases showed well defined tumor with homogeneous high density due to the thrombosis or hemorrhage within the orbit.MR imaging showed hypo- to hyperintense signal on T1-weighted images,had hyperintense signal on T2-weighted MR images. However, signal of lesions of orbital hemorrhage could be various according to the different hemorrhage time.Conclusion DOVM usually occurs in young patients.Clinical diagnosis can be established with the typical symptoms and one or more imaging examinations.%目的 探讨眼眶扩张型静脉畸形的临床特点和影像学检查的诊断价值和特征.方法 回顾性系列病例研究.对2000年8月至2010年7月第二军医大学附属长征医院眼科收治的临床和影像学资料完整的43例眼眶扩张型静脉畸形患者进行分析.结果 患者中男性19例,女性24例,年龄5～71岁,平均32岁；病变位于表浅部9例,深部19例,混合型12例,复杂性3例.25例具典型的体位性眼球突出症状.8例因眶内自发性出血而致急性眶压增高.B超检查表现为间歇性无回声区；彩色多普勒血流成像检查加压后显示红色血流信号,压力解除过程中,血流方向改变；35例CT检查显示水平位未见明显异常或可见轻度扩张的病变,而冠状位CT示病变体积显著增大.8例显示为边界较清晰、均质、形状不规则的高密度影,为眶内出血所致.MRI征象多表现为T1WI中、低信号,T2WI高信号.急性眶内出血时,因出血时间的不同而信号各异.结论 眼眶扩张型静脉畸形多发生于年轻患者,男女发病比例无明显差异.临床和影像学的征象结合临床表现即可做出正确的诊断.
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