Pınar NERCİS KOŞAR, Sonay AYDIN, Fatma Dilek GÖKHARMAN

ORBİTA KİTLELERİNİN TANI VE AYIRICI TANISINDA BTNİN KULLANIMI

Ankara Hastanesi Radyoloji Bölümünde tümör veya tümör benzeri lezyon ön tanısı ile BT tetkiki yapılan ve aynı nedenlerle opere edilmiş olguların BT bulguları incelenerek, tiroid oftalmopati dışında 40 olgu çalışma kapsamına alındı. Histopatolojik sonuçlarla, BT bulgulan karşılaştırılarak orbital kitlelere spesifik BT kriterleri ve BT'nin tanı değeri araştırıldı. 40 olgunun 22'si primer tümör (%55), 6'sı sekonder tümör (%12.5), 12'si (%32.5) tümör benzeri lezyondu. Sonuç olarak; ➢BT, intratümoral kalsifikasyonların, kemik yapılardaki sklerotik ve destrüktif değişikliklerin saptanmasında çok duyarlıdır. ➢BT ile intraorbital yer kaplayan lezyonların lokalizasyonu ve çevre dokulara yayılımı net olarak belirlenebilmektedir. ➢İntraoküler lezyonlar, USG ile korele edildiğinde spesifik tanılara ulaşılabilmektedir. ➢Orbital BT ile benign ve malign tümoral lezyonlar ile inflamatuar ve vasküler lezyonların ayıcı tanısı yapılabilmekte, spesifik tanıya gidilemeyen olgularda, BT lezyonun sınırlarını ve morfolojik özelliklerini belirleyerek tedaviyi yönlendirmektedir. BT ile spesifik tanı konabilme oranı; BT bulgularının anamnez, fizik muayene ve diğer radyolojik görüntüleme yöntemlerinin sonuçlarıyla beraber değerlendirildiği ölçüde artış gösterecektir.

THE USE OF CT IN THE DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS OF ORBITAL MASSES

This study includes patients with the pre-diagnosis of orbital spaceoccupying tumor or tumor-like lesions examined on CT in AnkaraTraining and Research Hospital Radiology Department. Thyroidophthalmopathy cases were not included in the study.CT criteria specific to orbital mass lesions and the diagnostic valueof CT were investigated through comparison of the CT findingswith the histopathological results. Of a total of 40 patients, 22 (55%) were diagnosed with primary tumors, 6 (12.5 %) with secondarytumors and 12 (32.5 %) with tumor-like lesions.CT is highly sensitive in the definition of intra-tumoral calcifications,and sclerotic and destructive changes in osseous structures. Thelocation and local invasion of intraorbital space-occupying lesionscan be clearly differentiated on CT. Diagnosis of intraocular lesionscan be made specifically, correlating CT findings with orbitalultrasound results.The differential diagnosis of benign and malignant tumoral lesionsfrom inflammatory and vascular lesions can be made using CT.In some cases where no specific diagnosis can be made, CTdirects the therapy by identifying the outlines and morphologicalcharacteristics of the lesion. The diagnostic specificity of CT willsurely increase in the light of anamnesis, physical examinationfindings and other radiological modalities.

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