全泪道MR成像——透明质酸钠的应用  

MR technology to entire lacrimal system:Application of sodium hyaluronate

作　　者：田俊[1] 杨亚芳[1] 娄斌[2] 刘斐[1] 

机构地区：[1]南京医科大学第二附属医院影像科,江苏南京210011 [2]南京医科大学第二附属医院眼科,江苏南京210011

出　　处：《中国医学影像技术》2014年第7期1011-1014,共4页Chinese Journal of Medical Imaging Technology

基　　金：南京医科大学第二附属医院新技术;新项目

摘　　要：目的探讨利用透明质酸钠做全泪道成像的可行性。方法对27例(54侧)溢泪和(或)溢脓患者进行磁共振全泪道扫描。9例(18侧)泪道以生理盐水做对比剂为第1组,18例(36侧)泪道以透明质酸钠做对比剂为第2组,分别行三维快速恢复快速自旋回波序列扫描。以泪道内镜为金标准,评价三维快速恢复快速自旋回波序列对泪小管、泪囊和鼻泪管的显像情况。结果泪小管:1组中,能显示但信号较低2侧、无显示16侧;2组中,清晰显示35侧、能显示但信号较低1侧。泪囊:1组中,清晰显示13侧、能显示但信号较低5侧;2组中,清晰显示36侧。以内镜为金标准,1组方法诊断鼻泪管通畅度准确率为77.77%(14/18),2组方法诊断鼻泪管通畅度准确率为97.22%(35/36),差异有统计学意义(P<0.05)。结论利用透明质酸钠行MR全泪道水成像能为眼科医生提供更详尽的信息,有利于提高手术的成功率。Objective To investigate the MRI practicability of entire lacrimal system using sodium hyaluronate. Methods Twenty-seven patients （54 lacrimal ducts） underwent MRI to entire lacrimal system with epiphora and/or pyorrhea symptom. Nine cases （18 lacimal ducts） with sterile saline as a contrast agent for the first group and 18 cases （36 lacrimal ducts） with sodium hyaluronate as a contrast medium for the second group underwent three dimensional fast recovery fast spin echo sequence scanning. Taking lacrimal endoscopy as the gold standard, imaging of lacrimal canaliculus, lacrime sacs and nasolacrimal ducts were evaluated. Results For the lacrimal canaliculus, none displayed clearly in the first group and 35 sides displayed clearly in the second group, 2 sides showed lower sign in the first group and 1 side in the second group, 16 sides were unable to display in the first group and none in the second group. For the lacrimal sacs, 13 sides displayed clearly in the first group and 36 sides in the second group, 5 sides showed lower sign in the first group. Accuracy of method in the first group in diagnosis of nasolacrimal duct patency was 77.77%（14/18） and that of in the second group was 97.22%（35/36）, the difference had statistical significance （P〈0.05）. Conclusion Using sodium hyaluronate in MR whole lacrimal duct imaging can provide more detailed information for ophtalmologists, and helps to improve the success rate of operation.

关 键 词：鼻泪管 磁共振成像 透明质酸钠 

分 类 号：R777.2[医药卫生—眼科] R445.2[医药卫生—临床医学]