ABSTRACT
Objective To investigate the value of the imaging division and features of CT and MRI in the differential diagnosis of benign and malignant space-occupying lesions.Methods A retrospective analysis of the clinical and imaging data of 201 patients with orbital space-occupying lesions confirmed by pathology was conducted.Four sector method was used to analyze the distribution of the lesions.The shape,border and relationship with surrounding tissues,MRI signal,CT density,and calcification of the orbital wall were also analyzed.Results There was statistical difference in the distribution of lesions in each of the 4-sector between orbital benign lesions and malignant tumors(χ2总=48.93,P=0.000).Lesions located in separate orbital zone including extra-periosteum compartment (18 cases),optic nerve compartment (4 cases),intraconal compartment(39 cases) were benign.Benign lesions (64%, 66/103) were more than malignant lesions (36%,37/103) in 103 lesions located in extraconal compartment.Additionally,there was significance in the distribution in separate and mixed zones between benign and malignant lesions(χ2=25.559,P=0.000).Benign lesions (77%,127/164) were more than malicious lesions(23%,37/164) in 164 cases in separate zone.Malignant lesions (65%,24/37) were more than benignant lesions (35%,13/37) in the 37 lesions located in mixed zone.Signs of CT and MRI:the benign and malignant lesions were 140 and 61,respectively.The features of those lesions are as follows(ratio=benign lesions/ malignant lesions):regular morphology(ratio=93/10),clear boundary(ratio=108/24),eyeball-surrounded (ratio=24/39),bone destruction (ratio=4/11).Features of lesions including shape,border,eyeball-surrounded, bone destruction had significant difference between benign and malignant lesions,whereas no differences was observed in calcification,signal on T1WI or T2WI,displacement of the eyeball and the occurrence of single or bilateral lesions.Conclusion The characteristic distribution of orbital space-occupying lesions based on the 4-sector and the features of CT and MRI has a great value in the diagnosis.
ABSTRACT
Objective To investigate the features of digital subtraction angiography(DSA) of meningioma and the application of therapy in preoperative embolization.Methods DSA in 36 cases with meningioma proved pathologically was performed.Of them,22 cases which the blood supply of tumor was mostly by external carotid artery were undergone external carotid artery embolization and surgical incision 3~10 days after embolization.Results Among 36 cases,the blood supply of tumor was only from external carotid artery in 9 cases,both of external and internal carotid artery supply in 25,and only internal carotid artery in 2.Among 22 cases undergone embolization of supplying artery the tumor stain absolutely disappeared in 16,evidently decreased in 6.22 cases undergone surgical incision after embolization,the tumors were wholly resected,average bleeding 150~500 ml during surgery.Conclusion The blood supply of meningioma can be only by external or internal carotid artery,or both.Preoperative cerebral angiographies and embolization are beneficial for the total resection of meningioma and reduction of bleeding during surery.