Levitt M, Coumou A D, Groeneveld L, Freling N J M, van der Horst C M, Saeed P
Department of Ophthalmology .
Orbit. 2014 Jun;33(3):178-83. doi: 10.3109/01676830.2014.884148. Epub 2014 Feb 25.
To highlight the importance of Magnetic Resonance Imaging (MRI) and the use of propranolol as both a final diagnostic tool and adequate treatment for orbital Infantile Haemangiomas (IHs).
A retrospective study was conducted using a case series of 5 infants diagnosed with orbital IH. All patients presented with progressive unilateral proptosis and were at high risk of developing amblyopia, some had combined swelling of the eyelid, impaired eye movements or exposure keratopathy. Propranolol was administered in an initial dose of 0.6 mg/kg/day orally divided in three daily doses and increased in 4 days to 2.7 mg/kg/day. MRI was performed in all children.
Striking MR characteristics of an IH lesion were seen in each of our 5 cases, including the presence of flow voids, high contrast enhancement, hypo-intense T1W signal, iso- to hyper intense T2W signal, and lobulated appearance. All patients showed a quick clinical response to treatment, resulting in significant reduction in tumour size within a range of 1-3 weeks and almost complete regression of the lesion at the end of the treatment schedule.
Our study adds another 5 cases to the growing body of reports confirming the efficacy and safety - under controlled circumstances - of propranolol therapy in orbital IH management, in which we highlight the use of propranolol as both a final diagnostic tool and as an adequate treatment.
强调磁共振成像（MRI）以及普萘洛尔作为眼眶婴幼儿血管瘤（IHs）最终诊断工具和有效治疗方法的重要性。
采用回顾性研究，纳入5例诊断为眼眶IH的婴儿病例系列。所有患者均表现为进行性单侧眼球突出，并有发生弱视的高风险，部分患者合并眼睑肿胀、眼球运动障碍或暴露性角膜病变。普萘洛尔初始剂量为0.6 mg/kg/天，口服，分三次给药，4天后增至2.7 mg/kg/天。所有患儿均接受了MRI检查。
在我们的5例病例中，每例均可见IH病变显著的MR特征，包括流空现象、高对比度增强、T1加权像低信号、T2加权像等信号至高信号以及分叶状外观。所有患者对治疗均表现出快速的临床反应，肿瘤大小在1 - 3周内显著减小，治疗结束时病变几乎完全消退。
我们的研究在越来越多的报告基础上又增加了5例，证实了在可控情况下普萘洛尔治疗眼眶IH的有效性和安全性，我们强调普萘洛尔作为最终诊断工具和充分治疗方法的应用。
