20MHzB型超声与频域光学相干断层扫描在黄斑病变诊断中的对比观察  

Comparison of 20 MHz B-scan ultrasound with spectral domain optical coherence tomography in the diagnosis of maculopathy

作　　者：林松[1] 漆晨[1] 赵乐冬 陈璐[1] 

机构地区：[1]天津医科大学眼科中心,300384

出　　处：《中华实验眼科杂志》2012年第1期63-66,共4页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景黄斑区病变的形态学检查在疾病的早期诊断中发挥着重要作用。频域光学相干断层扫描（OCT）在屈光间质混浊眼的检查受到限制，传统的10MHzB型超声检查对黄斑病变的分辨率较低，20MHzB型超声检查在黄斑区疾病中的应用是一种新的方法。目的应用频域OCT和20MHzB型超声对黄斑病变进行形态学对比观察，探讨20MHzB型超声对黄斑疾病的临床诊断价值。方法收集在天津医科大学眼科中心确诊的黄斑病变患者51例51眼，患眼均行频域OCT扫描，然后行20MHzB型超声检查。黄斑病变按频域OCT检查的形态学改变进行分类，分析20MHzB型超声的声像学特征，探讨病因。结果根据频域OCT检查检出黄斑裂孔10眼，B型超声显示黄斑区实性圆顶状回声表浅隆起，病变中央呈孔状凹陷。频域OCT检出的黄斑水肿16眼、神经上皮层脱离6眼和视网膜劈裂4眼，B型超声均显示黄斑区球壁表面的局限性带状表浅隆起，其下见液性无回声间隙。频域OCT检出的视网膜色素上皮（RPE）层脱离15眼，B型超声检查显示黄斑区球壁表面局限带状强回声表浅隆起，光带较厚，其下见液性无回声间隙。结论20MHzB型超声能对几种常见的黄斑病变进行初步鉴别，与频域OCT相比，黄斑病变B型超声表现的识别能力稍欠，但在屈光问质混浊的情况下，B型超声的诊断作用优于频域OCT。Background The morphological examination of macular disease is very important information for the early diagnosis. Spectral domain optical coherence tomography （SD-OCT） is a gold criteria in the diagnosis of macular diseases,but its clinical application is limited in the eyes with refractive medium opacity. The resolution ratio of conventional B-scan sonography is unsatisfactory. 20 MHz B-scan sonography may be a new approach to maculopathy. Objective This study was to evaluate the clinical value of 20 MHz B-scan ultrasound by comparing morphological changes of different maculopathies observed by 20 MHz ultrasound and spectral-domain OCT. Methods A prospective study was designed. 51 eyes of 51 patients with maeular diseases who were determined by Tianjin Medical University Eye Center were enrolled in this study. Spectral-domain OCT was used to image the macular area, and then the 20 MHz B-scan ultrasound was used to examine the same eye to assess the value of 20 MHz B-scan ultrasound diagnosis. The macular diseases were typed according to the OCT manifestation. The characteristics of 20 MHz ultrasound for the same maculopathy were analyzed. All the patients subscribe the informed consent before the study. Results In 10 eyes with macular hole determined by spectral-domain OCT,shallow dome-shaped lesion with central hollow was exhibited on the ultrasound image. The macular edema, retinal neuroepithelium layer detachment and retinoschisis were found in 16 eyes,6 eyes and 4 eyes by spectral-domain OCT, but the 20 MHz B- Scan ultrasound presented with the focal belt-shaped elevation with non-echo zone below. In contrast, in 15 eyes of retinal pigment epithelium detachment in OCT, spectral-domain OCT showed stronger and thicker beh-shaped echo.Conclusions 20 MHz B-scan ultrasound has certain value in the diagnosis and differentiation for several common maculopathies. Although it is not accurate as OCT in recognizing diseases,it could play an important role in refractive media opacity eye.

关 键 词：B型超声/20 MHz 光学相干断层扫描/频域 黄斑病变 医学影像学检查 

分 类 号：R774.5[医药卫生—眼科]