Kaiser Permanente South Bay, Los Angeles, California.
Department of Ophthalmology, Gavin Herbert Eye Center, University of California, Irvine, Irvine, California.
Ophthalmic Plast Reconstr Surg. 2020 Jul/Aug;36(4):359-364. doi: 10.1097/IOP.0000000000001553.
To report the characteristic clinical and imaging findings in a series of patients with thrombosed orbital venolymphatic malformations.
Patients affected by acute thrombosis of an orbital venolymphatic malformation were reviewed. Clinical findings including symptoms and signs of presentation, characteristic imaging features, and clinical course are presented.
Ten patients were identified. The mean age at presentation was 56 years. All patients presented with acute pain or pressure sensation, with the most common additional presenting symptoms being proptosis (6/10) and diplopia (5/10). CT imaging typically demonstrated a nonspecific orbital mass. Nine patients underwent MRI which revealed a soft tissue mass with peripheral rim enhancement and a central, typically T2 hypointense, core. Seven out of 10 patients were observed and had improvement in symptoms and signs without surgical intervention. Two patients underwent surgical intervention for intractable pain.
Patients with thrombosis of a venolymphatic malformation often present with acute pain, proptosis, and diplopia. Characteristic MRI findings of a peripheral rim enhancing mass with a T2 hypointense core can be noted. Careful observation is a reasonable management option for cases without visual compromise or intractable pain.
报告一系列血栓性眼眶静脉淋巴管畸形患者的特征性临床和影像学表现。
回顾了急性眼眶静脉淋巴管畸形血栓形成的患者。介绍了临床表现，包括发病时的症状和体征、特征性影像学特征和临床病程。
共发现 10 例患者。发病时的平均年龄为 56 岁。所有患者均出现急性疼痛或压迫感，最常见的其他症状为眼球突出（6/10）和复视（5/10）。CT 成像通常显示非特异性眶内肿块。9 例患者接受 MRI 检查，显示软组织肿块伴外周边缘增强，中央呈典型 T2 低信号核心。10 例患者中有 7 例未经手术干预观察，症状和体征改善。2 例患者因顽固性疼痛而行手术干预。
静脉淋巴管畸形血栓形成的患者常表现为急性疼痛、眼球突出和复视。特征性 MRI 表现为外周边缘增强肿块伴 T2 低信号核心。对于无视力损害或顽固性疼痛的病例，仔细观察是合理的治疗选择。
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