目的:探讨眼眶影像学新五分区在眼眶占位性病变中的诊断价值。方法:回顾性分析374例眼眶占位性病变患者的临床及影像资料,按眼眶影像学新五分区法(眼球区、视神经鞘区、肌锥内区、肌锥外区、骨膜外区)对其分布进行统计分析,探讨新五分区法下眼眶占位性病变的分布规律。结果:374例患者中血管瘤最常见,占总病例数的34.75%(130/374),其中79.23%(103/130)分布于肌锥内区。淋巴瘤分布以锥外单区域为主,炎性假瘤的分布多见于混合区域(χ^213.63,P〈0.001)。病例数超过10例的眼眶占位性病变各区的分布差异有统计学意义(P=0.001)。良、恶性病变在肌锥内区、外区及混合型的分布差异有统计学意义(χ^2/外=66.53,P〈0.001;χ^2/混=88.17,P〈0.001;χ^2/混=5.078,P=0.024〈0.05)。肌锥内区良性病变(99.18%,121/122)〉肌锥外区(56.12%,78/139)〉混合型(36.96%,17/46);恶性肿瘤混合型(63.04%,29/46)〉肌锥外区(43.88%,61/139)〉肌锥内区(0.82%,1/122)。结论:眼眶影像学新五分区下各分区眼眶占位性病变的分布具有一定的规律,新五分区法有助于眼眶占位性病变的诊断。
Objective:To discuss the diagnostic value of the new 5-sector approach for orbital imaging division in the diagnosis of orbital space-occupying lesions. Methods.. We retrospectively analyzed the clinical and imaging data of 374 patients with orbital space-occupying lesions. The distribution of the lesions was analyzed according to the new 5-sector approach for orbital imaging division (globe compartment, optic nerve compartment, intraconal compartment, extraconal compartment and extra-periosteum compartment) and the distribution rule of the lesions were discussed. Results: Hemangioma was the most common lesion among our group, with an incidence of 34.75 % (130/374) ; 79.23% (103/130) of the hemangiomas were distributed in the intraconal compartment. There was a distributional difference between the lymphoma and inflammatory pseudotumor(χ^2= 13. 63, P:0. 001), with the former mainly located in the extraconal compartment and the latter often in the mixed compartments. We also found that there were distributional differences for those lesions which had more than 10 sufferers in our study(χ^2=: 788. 058, P: 0. 001). Significant differences were also noted in the distribution of both benign and malignant lesions in the intraconal, extraconal and mixed type compartment(χ^2intra/extra=66.53, P〈0.001; Х^2intra/mixed= 88.17, P〈0.001 ; Х^2intra/mixed= 5. 078, P〈 0.05). For the benign lesions, the incidence order was: the intraconal compartment (99.18%, 121/122)〉 extraconal compartment (56.12% ,78/139)〉 mixed type(36.96%, 17/46); for the malignant lesions, the incidence order was: mixed type(63. 04% ,29/46)〉 extraconal compartment(43.88% ,61/139)〉 intraconal compartment(0.82%, 1/122). Conclusion: There are distributional differences in orbital space-occupying lesions under the new 5-sector approach for orbital imaging division, indicating that the new 5-sector approach is helpful in the diagnosis of orbital lesions.