眶部肌锥外间隙病变的CT表现

摘要

目的：探讨眶部肌锥外间隙疾病的CT影像表现及诊断价值。方法对诊断明确的34例累及眶部肌锥外间隙病变的影像学资料进行回顾性分析。均行CT平扫检查，29例行增强扫描，18例行冠状位扫描或重建。结果海绵状血管瘤8例，CT示类圆形、均匀软组织影，增强后呈明显、持续性强化。淋巴瘤8例，表现为不规则等密度软组织影，呈轻中度均匀强化。神经鞘膜瘤3例，表现为密度不均肿块，增强后不均匀强化，2例内见囊变影。（表）皮样囊肿7例，其内可测得负CT值区，囊壁轻度强化。炎性假瘤5例，CT示眼外肌肌腹、肌腱同时增粗，泪腺肿大等。蜂窝织炎2例，CT表现为条形、片状软组织影，呈宽基底。转移瘤1例，表现为圆形、边界不清的病灶，邻近骨质破坏。结论 CT检查对眼眶肌锥外间隙病变具有重要的价值，对大多数病变可作出明确诊断。%Objective To evaluate the appearances of extraconal orbital diseases and the value of Diagnosing on CT. Methods 34 patients with extraconal orbital disease identified pathologically were analysed retrospectively. All of them performed plain CT scan,and 29 cases performed contrast enhancement,18 cases obtained coronal CT scans or reconstructed. Results The cavernous hemangioma was found in 8 cases,which had similar round and homogeneous soft tissue shadow on CT,they showed obvious and persistence enhancement;The malignant lymphoma was found in 8 cases,which had irregular soft tissue with isodense on CT,and showed homogeneous mild-moderate enhancement;The neurilemmoma was found in 3 cases,which had heterogeneous density mass and showed heterogeneous enhancement;(Epidermoid)Dermoid Cysts was found in 7 cases,all could be detecked with areas of negative CT value,and the wall of Cysts showed mild enhancement;Inflammatory Pseudotumor was found in 5 cases,which showed the enlargement of entire muscles including the tendinous insertion and enlargement of lacrimal gland on CT;Orbital Cellulites was found in 2 cases,showed strip or platy soft tissue with broad substrate;The metastatic tumor was found in 1 cases,which was rould shape and unclear margin,and the adjacent bone was absorpted. Conclusion CT scan had great value in diagnosing extraconal orbital diseases,and the diagnosis of orbital neoplasms in most cases could be made correctly .