先天性泪囊突出的CT影像特征及治疗  

Imaging characteristics on computed tomography of congenital dacryocystocele and their role on guiding treatment

作　　者：李程[1] 崔燕辉[1] 于刚[1] 吴倩[1] 李莉[1] 张燕[1] 梁天蔚[1] 张诚玥[1] LI Cheng;CUI Yan-hui;YU Gang;WJJ Qian;LI Li;ZHANG Yan;LIANG Tian-wei;ZHANG Cheng-yue(Department of Ophthalmology,Beijing Children's Hospital,National Key Discipline of Pediatrics,Ministry of Education,National Children's Health Center,Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院眼科儿科学国家重点学科国家儿童医学中心,100045

出　　处：《眼科》2018年第6期456-459,共4页Ophthalmology in China

摘　　要：目的探讨先天性泪囊突出的CT影像特征及其对治疗方式选择的指导作用。设计回顾性病例系列。研究对象2008年6月至2015年6月北京儿童医院眼科先天性泪囊突出患儿24例(38眼)。方法分析患儿的CT影像特征,总结其手术方式及术后效果。主要指标CT影像特征、治疗方式、术后效果。结果所有患者CT显示患侧泪囊区呈类圆形囊性低密度肿物影像,骨性鼻泪管扩大,伴有或不伴有下鼻道肿物。5例(5眼,13.2%)行保守治疗2周后肿物消失。19例(33眼,86.8%)伴发急性泪囊炎、呼吸窘迫或经保守治疗2周后无效而手术治疗。其中,无下鼻道肿物的5例(8眼,21.1%),局麻下泪道探通术后内眦肿物消失。存在下鼻道肿物的14例(25眼,65.8%),全麻下鼻窦内窥镜下造口术,术后内眦及下鼻道肿物全部消失。结论 CT检查不仅可清晰显示先天性泪囊突出的解剖特征,也为手术治疗方式选择提供影像学支持。Objective To evaluate the role of computed tomography (CT) in the diagnosis and treatment of congenital dacryocystocele. Design Retrospective case series. Participants 24 cases (38 eyes) with congenital dacryocystocele from June 2008 to June 2015 in Beijing Children's Hospital. Methods CT characteristics of 24 cases (38 eyes) were investigated. The surgical methods and postoperative effects were also assessed retrospectively. Main Outcome Measures CT characteristics, treatment methods, and the efficacy. Results The common CT feature of congenital dacryocystocele was a round cystic image with low density at inner canthus, ipsilateral nasolacrimal canal enlargement with or without the inferior nasal passage mass. The inner canthus mass of 5 cases (5 eyes, 13.2%) disappeared after two weeks5 conservative therapy. 19 cases (33 eyes, 86.8%) with acute dacryocystitis, respiratory distress and no regression after two weeks conservative treatment were subjected to diverse surgeries. 5 cases (8 eyes,21.1%) without inferior nasal passage mass demonstrated by CT underwent probing under local anesthesia. The inner canthus mass all disappeared after the surgeries. 14 cases (25 eyes,65.8%) with inferior nasal passage mass verified by CT underwent endoscopic marsupialization under general anesthesia. The masses at the inner canthus and inferior nasal passage disappeared after the operations. Conclusion Computed tomography not only can show the prominent anatomical feature of congenital dacryocystocele definitely, but also can provide ancillary effect in surgical choice.

关 键 词：先天性泪囊突出 计算机断层扫描 

分 类 号：R779.6[医药卫生—眼科]