Investigation On Imaging Differential Diagnosis Between Orbital Cavernous Hemangioma And Orbital Neurilemmoma

Objective: Both orbital cavernous hemangioma and orbital neurilemmoma are common orbital tumors. They two have similarities on matter the confluence of the disease, age, gender, clinic sign or the formation, position of the tumor. However, they differ in the option of operation and treatment because the correct pre-operation diagnosis is the foundation for the right treatment. Imaging investigation is the best one for orbital cavernous hemangioma. Based on the different structures of the different tumor tissue, various image diagnosis investigations can reflect the respective clinic sign. Then, according to the features, the suitable investigation to differ the two kinds of tumors can be found.Methods: The paper sums up my faculty's verification on the reflection of the twenty-five cases of orbital cavernous hemangioma and twenty-four cases orbital neurilemmoma via B - mode, CDFI, CT,MRI, also concludes all kinds of the imaging features reflected from various checks, afterwards, based on results distinguish, statistic analyses. Finally, the most suitable way for differentiate the image investigation on the two kind tumor is found.The statistic software SPSS 13.0 is used to process the stat.Results: The position diagnosis accordance ratio of B-mode, CDFI, CT, MRI for the orbital cavernous hemangioma are 45%,47%,88%,100%(table 1), B-mode and CT (P = 0.003<0.01), B-mode and MRI (P=0.004<0.01), CDFI and CT (P=0.009<0.01), CDFI and MRI (P=0.008<0.01), obvious differences exist, statistically meaningful. It reveals that the correct ratio of MRI and CT in position diagnosis is higher than B-mode and CDFI. The accordance ratio of qualitative diagnosis are 80%, 87%, 40%(contrast enhancement scan is 93%),70%(contrast enhancement scan is 100%). B-mode and plain CT scan (P=0.014<0.05), CDFI and plain CT scan (P=0.007< 0.01),obvious differences exist, statistically meaningful. It means that accordance ratio of B-mode and CDFI is higher than plain CT scan investigation, while there is on statistical difference plain MRI scan and B-mode (P=0.657>0.05) between plain MRI scan and CDFI (P=0.358> 0.05) . So, there is on obvious difference on determine diagnosis ratio between ultrasonic investigation and MRI investigation. With the contrast enhancement of CT scan, B-mode and the CT(CE) (P=0.365>0.05), CDFI and CT(CE) (P =1.000>0.05), it is meaningless statistically. Though, it is meaningless in this sense, the after-check on the eight patients MRI scanned, all determine investigation are correct, accordance ratio is 100%. Contrast enhanced than before (70%) was significantly improved, it is more obvious. So we can say contrast enhancement on CT and MRI is a necessary investigation means.Table 1 The Location and Qualitative for Diagnostic Accordance Rate of Varied Imaging Examination on Orbital Cavernous Hemangioma The position diagnosis accordance ratio of B-mode, CDFI, CT, MRI for the orbital neurilemmoma are 42%, 47%, 92%, 100%(table 2), B-mode and MRI(P=0.000<0.05), B-mode and CT (P=0.001<0.05), CDFI and MRI(P=0.001<0.05), CDFI and CT(P=0.003<0.05), obvious differences exist, statistically meaningful. It reveals that the correct ratio of MRI and CT in position diagnosis is higher than B-mode and CDFI. The accordance ratio of qualitative diagnosis are 46%, 53%, 46%(contrast enhancement scan is 47%), 88%(contrast enhancement scan is 91%). B-mode and MRI(P=0.008<0.01), B-mode and MRI (CE) (P=0.023<0.05) , CDFI and plain MRI scan (P = 0.049<0.05),plain CT scan and plain MRI scan(P=0.008<0.05), CT (CE) and MRI(CE) (P=0.036<0.05) , obvious differences exist, so it is statistically meaningful. CDFI and MRI (CE) (P = 0.084>0.05) are statistically meaningless. But accordance ration of position diagnosis of CDFI is 53%, MRI(CE) is 91%, MRI(CE) is much higher than CDFI investigation. It confirms that no matter MRI (CE) or not, its qualitative diagnosis accordance ratio is higher than any other investigation means. MRI(plain scan + contrast enhancement scan) investigation has the highest accordance ration.Table 2 The Location and Qualitative for Diagnostic Accordance Rate of Varied Imaging Examination on Orbital NeurilemmomaFor the position diagnosis of the two kinds of tumors, MRI is the most correct. The position diagnosis is higher than CT, while B-mode and CDFI are worse than MRI and CT. For the qualitative diagnosis, cavernous hemangioma's B-mode and CDFI investigation accordance ratio is higher than CT scan and MRI scan investigation. However, CT (CE) and MRI (CE) investigation scan, qualitative diagnosis accordance ratio is slightly higher than B-mode and CDFI. It reflects that CT (CE) or MRI (CE) scan is a necessary method for final diagnosis cavernous hemangioma and can greatly improve the determine diagnosis. The conclusion is that CT(CE) or MRI(CE) combining ultrasonic investigation(B-mode or CDFI),can diagnosis the cavernous hemangioma better. Neurilemmoma's MRI(plain scan + contrast enhancement scan) investigation accordance ratio is much higher than other kinds of investigation. B-mode , CDFI and CT investigation accordance ratio are mainly the same. So we can conclude MRI(CE) unites ultrasonography investigation(B-mode or CDFI) can diagnosis neurilemmoma correctly.Conclusion: by concluding the above two kinds of tumor's imaging best diagnosis method, we can conclude when it is difficult to differ relatively big cavernous hemangioma and neurilemmoma by using (contrast enhancement MRI scan + ultrasonography) investigation can greatly improve the accordance ratio of these two kinds of tumors in position and determine diagnosis, then various diagnosis can be chosen.