自发眼球内出血的磁共振影像及超声影像表现  

Magnetic resonance imaging and ultrasonography in 6 cases of spontaneous ocular hemorrhage

作　　者：李亚军[1] 肖立志[1] 周顺科[1] 肖满意[2] 高玲[2] 杨沛[3] 

机构地区：[1]中南大学湘雅二医院放射科,湖南长沙410011 [2]中南大学湘雅二医院眼科,湖南长沙410011 [3]海南省海口市解放军187医院放射科

出　　处：《眼科》2010年第2期105-108,共4页Ophthalmology in China

摘　　要：目的提高自发眼球内出血磁共振影像(MRI)诊断的准确性。设计回顾性病例系列。研究对象自发眼球内出血患者6例。方法回顾性分析经手术后病理证实的6例自发眼球内出血病例的影像资料,经灰阶超声检查6例,彩色多普勒检查5例,MR检查6例,其中MR增强检查5例。主要指标病变形态、信号、强化特点、声像特点。结果在MRI图像上,病灶新月形1例,扁豆状2例,驼峰状3例。短T1短T2、长T1长T2、短T1长T2信号各2例。T2WI上病灶有低信号环2例。5例病灶内部均无强化。其中2例病灶邻近眼环强化,1例病灶环形强化。MRI诊断正确2例,2例误诊为脉络膜黑色素瘤,2例误诊为肿瘤并出血;灰阶超声6例均诊断为肿块。彩色多普勒超声4例诊断为出血,主要依据为病灶内无血流信号,1例诊断为肿物。结论自发眼球内出血MR信号多变,病灶内部无强化是其主要特点。综合利用超声信息可以提高诊断的准确性。Objective To improve the accuracy with magnetic resonance imaging （MRI） diagnosis of spontaneous intraocular hemorrhage. Design Retrospective case series. Participants 6 patients with spontaneous intraocular hemorrhage. Methods The image findings were retrospectively analyzed in 6 patients confirmed by surgery with or without pathology. All of them were examined with ultrasonography and 5 cases with color uhrasonography. MRI was performed in 6 cases, and enhanced MRI in 5 cases. Main Outcome Measures Configuration, signal intense, characteristics of enhancement signal and uhrasonograph. Results 1 case was crescent shape on MRI of spontaneous intraocular hemorrhage, 2 cases were lenticular shape, 3 cases were hump shape. 2 cases showed high signal intensity on T1WI, and low signal on T2WI. 2 cases showed high signal on both T1 and T2WI. 2 cases showed low signal on T1WI, and high signal intensity on T2WI. 2 cases presented a ring with hypointensity on T2WI. No enhancement was revealed within the lesions in 5 cases. Liner enhancement was showed in 2 cases; ring enhancement was showed in 1 case. 2 cases were corrected diagnosed by MRI, 2 cases were misdiagnosed as melanoma, and 2 cases were misdiagnosed as tumor concomitant hemorrhage, and all cases were diagnosed as tumor with ultrasonography. With color Doppler imaging 4 cases were correctly diagnosed as hemorrhage based on without blood-flow signal, and 1 case was diagnosed as tumor. Conclusions The MRI signal characteristic of spontaneous ocular hemorrhage is variable, and the main feature is no enhancement within the lesion. MRI combined with uhrasonography can make the diagnosis more correctly. （Ophtholmol CHN, 2010, 19： 105-108）

关 键 词：玻璃体出血 眼肿瘤 视网膜脱离 磁共振成像 声像图 

分 类 号：R771[医药卫生—眼科] R445[医药卫生—临床医学]