眼眶炎性假瘤的CT诊断及鉴别诊断
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摘要
目的:本文探究CT应用在眼眶炎性假瘤患者中所取得的诊断效果,对CT应用在眼眶炎性假瘤患者的诊断价值展开评价。方法:本次于2017年10月-2018年10月选取25例眼眶炎性假瘤患者纳入研究之内,患者均接受CT检查,回顾性患者的临床资料和诊断结果。结果:在本次的检查之中,患者眼球均突出。肌炎型共10例(40.0%),眼外肌受累增粗且肌腱肥大,边缘毛糙,起肌腱止点处出现增粗,其中共3例患者外直肌增粗,内直肌增粗共6例,4例为上直肌增粗,7例为外直肌肉增粗,伴神经增粗共1例,2例患者伴眼球壁增厚;肿块型共3例(12.0%),患者眶内软组织肿块;弥漫型共2例(8.0%),充满眶内球后脂肪间隙密度出现增高,肌锥内脂肪间隙呈现不规则的条片高密度影,软组织且结构分解不清;混合型共9例(36.0%),眼外肌增粗并且合并周围脂肪密度增高,肿块合并眼外肌增粗,肿大泪腺合并相邻外直肌增粗,伴视神经增粗共3例,伴眼球壁增厚共2例;泪腺型共1例(4.0%),泪腺增大呈现处肿块,其中1例为不规则形,2例为蚕豆型。有9例患者出现了眼环增厚、神经增粗、病变出现不同程度的强化,并且伴有鼻窦炎。结论:眼眶炎性假瘤患者应用CT检查,可取得良好的诊断效果。CT检查在临床中较高的准确率,可对患者的眼眶炎性假瘤分型状况进行更为全面、准确的评价,有利于医师根据分型制定治疗方案,有利于改善患者的预后,值得推广。
Objective:To explore the diagnostic effect of CT in orbital inflammatory pseudotumors, and to evaluate the diagnostic value of CT in orbital inflammatory pseudotumors.Methods:From October 2017 to October 2018, 25 cases of orbital inflammatory pseudotumors were selected and included in the study. All patients underwent CT examination. The clinical data and diagnostic results were retrospectively reviewed.Results:During this examination, the eyeballs of all patients were prominent. There were 10 cases(40.0%) of myositis type. Extraocular muscles were involved and tendons were hypertrophic, the edges were rough, and there were enlargement at the starting point of tendon. Among them, 3 cases had enlargement of lateral rectus muscle, 6 cases had enlargement of medial rectus muscle, 4 cases had enlargement of superior rectus muscle, 7 cases had enlargement of lateral rectus muscle, 1 case had enlargement of nerve, and 2 cases had enlargement of eyeball wall. There were 3 cases(12.0%) with orbital soft tissue mass, 2 cases(8.0%) with diffuse type, and the density of fat space increased after filling the orbital sphere. The density of fat space in muscle cone showed irregular strips, and the structure of soft tissue was unclear. 9 cases(36.0%) with mixed type had enlarged extraocular muscles and combined with surrounding fat density. There were 3 cases of enlarged lacrimal gland with enlarged lateral rectus muscle, 2 cases of enlarged optic nerve, 1 case of lacrimal gland type(4.0%) and 2 cases of faba bean type with enlarged lacrimal gland. Nine patients had ocular ring thickening, nerve thickening, lesions with varying degrees of enhancement, and accompanied by sinusitis.Conclusion:CT examination of orbital inflammatory pseudotumors can achieve good diagnostic results. The high accuracy of CT examination in clinical practice can make a more comprehensive and accurate evaluation of the classification of orbital inflammatory pseudotumors, which is helpful for doctors to formulate treatment plans according to the classification, improve the prognosis of patients, and is worthy of promotion.
Objective:To explore the diagnostic effect of CT in orbital inflammatory pseudotumors, and to evaluate the diagnostic value of CT in orbital inflammatory pseudotumors.Methods:From October 2017 to October 2018, 25 cases of orbital inflammatory pseudotumors were selected and included in the study. All patients underwent CT examination. The clinical data and diagnostic results were retrospectively reviewed.Results:During this examination, the eyeballs of all patients were prominent. There were 10 cases(40.0%) of myositis type. Extraocular muscles were involved and tendons were hypertrophic, the edges were rough, and there were enlargement at the starting point of tendon. Among them, 3 cases had enlargement of lateral rectus muscle, 6 cases had enlargement of medial rectus muscle, 4 cases had enlargement of superior rectus muscle, 7 cases had enlargement of lateral rectus muscle, 1 case had enlargement of nerve, and 2 cases had enlargement of eyeball wall. There were 3 cases(12.0%) with orbital soft tissue mass, 2 cases(8.0%) with diffuse type, and the density of fat space increased after filling the orbital sphere. The density of fat space in muscle cone showed irregular strips, and the structure of soft tissue was unclear. 9 cases(36.0%) with mixed type had enlarged extraocular muscles and combined with surrounding fat density. There were 3 cases of enlarged lacrimal gland with enlarged lateral rectus muscle, 2 cases of enlarged optic nerve, 1 case of lacrimal gland type(4.0%) and 2 cases of faba bean type with enlarged lacrimal gland. Nine patients had ocular ring thickening, nerve thickening, lesions with varying degrees of enhancement, and accompanied by sinusitis.Conclusion:CT examination of orbital inflammatory pseudotumors can achieve good diagnostic results. The high accuracy of CT examination in clinical practice can make a more comprehensive and accurate evaluation of the classification of orbital inflammatory pseudotumors, which is helpful for doctors to formulate treatment plans according to the classification, improve the prognosis of patients, and is worthy of promotion.
引文
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2 赵丽娟.临床误诊为炎性假瘤的IgG4相关眼眶病1例[J].临床眼科杂志,2018,26(02):169.
3 李金茹,马建民,李静,王霄娜.PI3K信号通路中LCK、LAT、SYK、PKC基因在特发性眼眶炎性假瘤中差异表达分析[J].贵州医药,2018,42(02):137-139+257.
4 任继亮,吴颖为,陶晓峰.常规MRI纹理分析鉴别诊断眼眶淋巴瘤与炎性假瘤[J].中国医学影像技术,2017,33(07):980-984.
5 王大虎,刘新泉.眼眶炎性假瘤激素治疗后诱发中心性浆液性脉络膜视网膜病变1例[J].临床眼科杂志,2016,24(06):566-567.