磁共振成像技术3D FIESTA序列对溢泪病因分析的临床应用价值  

Clinical application value of MR dacryocystography using 3D FIESTA to analyze the cause of epiphora

作　　者：王悦[1] 周军[1] 陈琳琳[1] 李丹[1] 刘学[1] 朱越[1] 李聪[1] 

机构地区：[1]沈阳市第四人民医院,辽宁沈阳110031

出　　处：《中国临床医学影像杂志》2015年第2期77-80,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨应用MRI泪道成像技术3D FIESTA序列对明确溢泪病因的临床应用价值。方法:溢泪患者50例(溢泪64侧、正常36侧)行泪道MRI检查。检查前分4次向双眼结膜囊滴入0.9%的Na Cl注射液,扫描序列为三维快速平衡稳态序列(3D FIESTA)、三维快速恢复快速自旋回波序列(3D-FRFSE)和快速恢复快速自旋回波(FRFSE T2WI),并将3D FIESTA、3DFRFSE序列的原始图像做后处理及三维重建,观察溢泪患者泪道显示情况,并分析泪道阻塞的部位与原因。所有溢泪患者MRI检查后1周内进行内窥镜检查和治疗,将3D FIESTA、3D-FRFSE和FRFSE T2WI序列所得出的诊断与内窥镜检查结果进行对照分析。结果:64侧溢泪泪道与内窥镜结果进行对照,3D FIESTA序列能显示梗阻位置与病因61侧(95.3%),FRFSE T2WI显示53侧(82.8%),3D-FRFSE序列不能分析梗阻原因、显示梗阻部位42侧(65.6%),3D FIESTA序列诊断正确率显著高于FRFSE T2WI和3D-FRFSE序列,差异有统计学意义(χ2=14.135,P<0.05)。有2侧泪道功能不全和1侧泪点狭窄以上3种检查均未做出明确诊断。结论:3D FIESTA序列对于溢泪病因分析明显优于3D-FRFSE序列和FRFSE T2WI序列,对于帮助临床选择治疗方案有着重要的作用。Objective： To explore the value of MR dacryocystography using three-dimensional fast imaging employing steady-state acquisition（3D FIESTA） to analyze the cause of epiphora. Methods： Fifty epiphora patients（64 epiphora sides and36 healthy sides） underwent MRI lacrimal examination. 0.9% Na Cl saline was dropped to bilateral conjunctival sac four times before the exam. The scanning sequences included 3D FIESTA, three-dimensional fast recovery fast spin echo（3D-FRFSE） and fast recovery fast spin echo（FRFSE T2WI）. The original images were processed with curve and maximum intensity projection（MIP）. The structure around lacrimal ducts was observed and the reason and obstruction position of lacrimal ducts were ananlyzed. All patients underwent expert endoscopy examination and treatment within one week after the MRI scanning. 3D FIESTA, 3D-FRFSE and FRFSE T2 WI results were compared with endoscopy results. Results： Compared with endoscopy results of64 epiphora sides, 3D FIESTA could display the cause and position of obstruct in 61 sides（95.3%）, FRFSE T2 WI could display the cause and position of obstruct in 53 sides（82.8%）, 3D-FRFSE could not display the cause of obstruct, but could display the obstruct position in 42 sides（65.6%）. 3D FIESTA obviously preceded FRFSE T2 WI and 3D-FRFSE, and the difference was statistically significant（χ^2=14.135, P〈0.05）. Two lacrimal dysfunction and 1 stenosis of punctum were missed by all these three techniques. Conclusion： 3D FIESTA obviously precedes 3D-FRFSE and FRFSE T2 WI for analysis of the cause of epiphora, and it has important effect on choice of clinical treatment plan.

关 键 词：眼疾病 磁共振成像 

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