眼外伤性病变的影像学诊断  

A comparative study of imageology in lesions of eye trauma

作　　者：程敬亮[1,2,3,4] 任翠萍[1,2,3,4] 赵建国 汪浒[1,2,3,4] 毛晓明[1,2,3,4] 施光普 张效房 李树新[1,2,3,4] 

机构地区：[1]河南医科大学第一附属医院放射科 [2]河南医科大学第一附属医院眼科 [3]郑州铁路中心医院放射科 [4]河南省人民医院放射科

出　　处：《河南医科大学学报》1998年第2期1-5,共5页Journal of Henan Medical University

基　　金：河南省科技攻关项目

摘　　要：回顾性分析６８例（８０眼）眼外伤的Ｘ线平片、Ｂ超、ＣＴ和ＭＲＩ资料，比较其对眼外伤性病变的诊断价值。８０只伤眼中５７眼合并眼部异物，在合并的６９枚眼眶部异物中非磁性异物６５枚，磁性异物４枚。Ｘ线平片、Ｂ超、ＣＴ和ＭＲＩ对６９枚异物（眼球内４８枚，眼球壁１３枚，球后６枚，眼睑２枚）诊断的阳性率分别为４９％、７４％、９１％和９０％。６枚球壁和邻近球壁异物Ｘ线平片定位错误。ＭＲＩ诊断伤后１０～６２ｄ眼内出血１３眼，Ｂ超诊断４眼，ＣＴ未诊断１眼。Ｂ超诊断玻璃体混浊５８眼，ＭＲＩ和ＣＴ分别诊断３３眼和１１眼。４０眼外伤性白内障经Ｂ超、ＣＴ和ＭＲＩ分别诊断２０眼、２１眼和１８眼。ＣＴ和ＭＲＩ诊断２例球后脓肿，而Ｂ超未能诊断。ＣＴ诊断４例眼眶骨折，Ｘ线平片和ＭＲＩ各诊断２例。结果提示：ＣＴ和ＭＲＩ是检出眶内异物的最有效方法，Ｂ超主要适用于眼内和眼球壁异物的诊断；ＭＲＩ可检出Ｘ线平片和ＣＴ不能显示的少数非金属异物和较小铁异物；ＭＲＩ诊断眼内亚急性和慢性期出血优于ＣＴ和Ｂ超；ＣＴ诊断眶壁骨折优于ＭＲＩ和Ｘ线平片；? To determine the diagnostic value of various imageological methods in lesions of eye trauma,the data of orbital roentgenogram,BUS,CT and MRI in 80 eyes of 68 patients with eye trauma were analysed retrospectively.There were orbital roentgenogram,BUS,CT and MRI in all cases.Sixty nine eye foreign bodies(nonmagnetic 65,magnetic 4)were found in 57 of 80 eyes with eye traumas.The positive rates of 69 eye foreign bodies (intraocular 48,ocular wall 13,retroocular 6,eyelid 2)on roentgenogram,BUS,CT and MRI were 49%,74%,91% and 90% respectively.Six foreign bodies within ocular wall and around it were located by mistake on roentgenogram.Thirteen vitreous body hemorrhages were determined by MRI,4 were determined by BUS,and no one by CT 10～62 days after eye trauma.Vitreous opacities diagnosed by BUS,MRI and CT were 58,33 and 11 respectively.Of 40 traumatic cataracts determined by ophthalmologist,20、21、18 were deterimined by BUS,CT and MRI respectively.Two retroocular abscesses were detected by CT and MRI,but not by BUS.Two of 4 orbital fractures exhibited by CT were shown by MRI or roentgenogram.Our results suggested that:①CT or MRI was the most effective method for checking out eye foreign bodies,and BUS was mainly used to determine intraocular and ocular wall foreign bodies.②Some nonmetallic or small ferrous eye foreign bodies undetected by CT or roentgenogram could be shown on MRI.③MRI was superior to CT or BUS in revealing subacute and chronic intraocular hemorrhage.④CT was superior to MRI or roentgenogram in showing orbital fracture.⑤BUS was superior to CT or MRI in checking out vitreous opacity.

关 键 词：眼损伤 眼异物 并发症 放射诊断学 眼外伤 

分 类 号：R779.120.4[医药卫生—眼科] R816.97[医药卫生—临床医学]