20MHz B超联合UBM在脉络膜脱离型视网膜脱离诊断中应用  

The application of 20MHz B-scan and ultrasound biomicroscopy in the diagnosis of retinal detachment associated with choroidal detachment

作　　者：潘红飙 顾永昊 鲍建 柯根杰 

机构地区：[1]安徽医科大学附属省立医院眼科,安徽省合肥市230001

出　　处：《中国实用眼科杂志》2014年第12期1449-1453,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 利用20MHz B超联合UBM检查,完善脉络膜脱离型视网膜脱离的声像表现,提高脉络膜脱离型视网膜脱离的检出率,并探讨其发病机制.方法 临床病例系列研究.对2013年3月到6月在安徽医科大学附属省立医院检查收治的原发性裂孔性视网膜脱离的患者311例,其中男183例,女128例,年龄19～71岁,平均年龄（46.5±11.3）岁.患者行眼科常规检查和10MHz B超检查、20MHzB超检查、UBM检查.统计各自检出睫状体脉络膜脱离数进行统计学分析,并分析所得声像图.结果 311例原发性裂孔性视网膜脱离患者中,各种检查检出脉络膜脱离分别为：眼科体检11只眼,检出率3.54％ （11/311）,10MHzB超13只眼,检出率4.18％ （13/311）,与眼科体检的检出率差异无统计学意义（x2=0.17,P=0.68）; 20MHz B超20只眼,检出率6.43％ （20/311）,与眼科体检（x2=2.75,P=0.10）、10MHz B超（x2=1.57,P=0.21）检出率均差异无统计学意义;UBM 26只眼,检出率8.36％ （26/311）,显著高于眼科体检（x2=6.47,P=0.0l）和10MHz B超,差异有统计学意义（x2=4.62,P=0.03）,与20MHzB超差异无统计学意义（x2=0.84,P=0.36）; 20 MHzB超联合UBM 30只眼,检出率9.65％ （30/311）,显著高于10MHz B超,差异有统计学意义（x2=7.22,P=0.01）和眼科体检（x2=9.43,P=0.002）.结论 20MHz B超声联合UBM检查完善了脉络膜脱离型视网膜脱离声像表现,提高了脉络膜脱离型视网膜脱离检出率,同时说明脉络膜脱离可能先发生于睫状体和前段脉络膜,睫状体脱离可能是脉络膜脱离的早期表现形式之一.Objective To explore the value of using 20MHz B ultrasound combined with ultrasound biomicroscopy in diagnosis of the rhegmatogenous retinal detachment associated with choroidal detachment.Methods A total of 311 cases （311 eyes） of primary rhegmatogenous retinal detachment patients were included,which were composed by 183 males and 128 females,aged from 19 to 71 years old （mean age 46.5±11.3 years）.All patients underwent 10MHz B ultrasound,20MHz B ultrasound,ultrasound biomicroscopy （UBM） examinations respectively,and the images were recorded and assessed by a well-trained clinician.Analysis of X2 was adopted to compare the difference between 10MHz B ultrasound and 20MHz B ultrasound combined with ultrasound biomicroscopy.Results In 311 eyes of rhegmatogenous retinal detachment,11 eyes （3.54％） were detected associated with choroidal detachment by ophthalmological examination,13 eyes （4.18％） were detected associated with choroidal detachment by 10MHz B ultrasound,and the detection rate had no difference with ophthalmological examination （x2=0.17,P =0.68）,20 eyes （6.43％） were detected associated with choroidal detachment by 20MHz B ultrasound,and the detection rate had no difference with ophthalmological examination （x2=2.75,P =0.10） and 10 MHz B ultrasound （x2=1.57,P =0.21）,26 eyes （8.36％） were detected associated with choroidal detachment by UBM,and the detection rate was significantly higher than ophthalmological examination （x2=6.47,P =0.01） and 10 MHz B ultrasound （x2=4.62,P =0.03）,30 eyes （9.65％） were detected associated with choroidal detachment by combination of 10 MHz B ultrasound and UBM,and the detection rate was significantly higher than ophthalmological examination （x2=7.22,P =0.01） and 10 MHz B ultrasound （x2=9.43,P =0.002）.Conclusions Association of 20MHz B ultrasound and ultrasound biomicroscopy can significant improve the detection rate for rhegmatogenous retinal detachment associated with choroidal detachment.Cyclodialysis migh

关 键 词：20MHz B型超声 超声生物显微镜 脉络膜脱离型视网膜脱离 

分 类 号：R774.12[医药卫生—眼科]