为了研究磁共振成像（MRI）放射学在鉴别眼眶中的孤立性纤维瘤（SFT）和神经鞘瘤的价值，回顾性地纳入了来自两个机构的共计140名患者。从机构1的患者中随机分为训练组（n = 69）和验证组（n = 35），机构2的患者则用作外部测试组（n = 36）。从T2加权成像（T2WI）和增强T1加权成像（CET1WI）中提取了106个特征。采用最小绝对收缩和选择算子逻辑回归法构建了每个序列的放射学模型，并计算了放射学分数。还构建了一个组合模型，并以放射学的示意图形式展示出来。两位放射科医生根据MRI结果共同评估肿瘤类型。通过曲线下面积（AUC）比较了放射学模型和视觉评估的表现。在训练（AUC 0.986 vs. 0.807, p < 0.001）、验证（AUC 0.989 vs. 0.788, p = 0.009）和测试（AUC 0.903 vs. 0.792, p = 0.093）中，结合T2WI和CET1WI放射学分数的放射学示意图表现优于读者总体评估，尽管在测试队列中并没有发现显著差异。决策曲线分析表明，放射学示意图比视觉评估具有更好的临床效用。MRI放射学示意图可用于区分眼眶SFT和神经鞘瘤，这可能有助于临床医生对肿瘤的管理。区分眼眶中的孤立纤维瘤和神经鞘瘤具有重要性和挑战性。在本研究中，开发了一种基于MRI的放射学示意图，并进行了独立验证，可帮助区分这两种实体。•由于临床和影像特征相似，难以区分眼眶中的孤立性纤维瘤和神经鞘瘤。•基于T2加权成像和增强T1加权成像的放射学示意图具有胜过放射科医生的优势。•放射学可以提供一种非侵入性的诊断工具，用于区分这两种实体。© 2023。作者（们）在欧洲放射学协会的独家许可下。

To investigate the value of magnetic resonance imaging (MRI) radiomics for distinguishing solitary fibrous tumor (SFT) from schwannoma in the orbit.A total of 140 patients from two institutions were retrospectively included. All patients from institution 1 were randomized into a training cohort (n = 69) and a validation cohort (n = 35), and patients from institution 2 were used as an external testing cohort (n = 36). One hundred and six features were extracted from T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (CET1WI). A radiomics model was built for each sequence using least absolute shrinkage and selection operator logistic regression, and radiomics scores were calculated. A combined model was constructed and displayed as a radiomics nomogram. Two radiologists jointly assessed tumor category based on MRI findings. The performances of the radiomics models and visual assessment were compared via area under the curve (AUC).The performances of the radiomics nomogram combining T2WI and CET1WI radiomics scores were superior to those of the pooled readers in the training (AUC 0.986 vs. 0.807, p < 0.001), validation (AUC 0.989 vs. 0.788, p = 0.009), and the testing (AUC 0.903 vs. 0.792, p = 0.093), although significant difference was not found in the testing cohort. Decision curve analysis demonstrated that the radiomics nomogram had better clinical utility than visual assessment.MRI radiomics nomogram can be used for distinguishing between orbital SFT and schwannoma, which may help tumor management by clinicians.It is of great importance and challenging for distinguishing solitary fibrous tumor from schwannoma in the orbit. In the present study, an MRI-based radiomics nomogram were developed and independently validated, which could help the discrimination of the two entities.• It is challenging to differentiate solitary fibrous tumor from schwannoma in the orbit due to similar clinical and image features. • A radiomics nomogram based on T2-weighted imaging and contrast-enhanced T1-weighted imaging has advantages over radiologists. • Radiomics can provide a non-invasive diagnostic tool for differentiating between the two entities.© 2023. The Author(s), under exclusive licence to European Society of Radiology.