123例单纯性动眼神经麻痹的MRI病因学分析  

MRI findings of isolate oculomotor nerve palsy in 123 patients

作　　者：李建红[1] 燕飞[1] 鲜军舫[1] 王振常[1] 

机构地区：[1]首都医科大学附属北京同仁医院放射科,100730

出　　处：《眼科》2015年第5期304-308,共5页Ophthalmology in China

摘　　要：目的探讨单纯性动眼神经麻痹的MRI表现及病因。设计回顾性病例系列。研究对象123例单纯性动眼神经麻痹患者。方法回顾性分析患者的MRI表现,结合动眼神经的解剖特点,分析动眼神经麻痹的病因。主要指标MRI表现。结果 123例动眼神经麻痹病例中,MRI表现异常者87例(70.7%)。其中海绵窦区病变62例(71.2%)(炎症45例,颈内动脉动脉瘤8例,鼻咽部/蝶窦/鞍区/鞍旁占位性病变累及海绵窦者6例,颈内动脉海绵窦瘘2例,颈内动脉海绵窦段增粗迂曲1例);脑干病变16例(18.4%)(中脑梗塞15例,中脑炎症1例);颅眶沟通性病变5例(5.7%)(炎症3例,肿瘤2例);动眼神经脑池段及其周围病变4例(4.6%)(动眼神经炎性病变2例,动眼神经神经鞘瘤1例,脚间池胆脂瘤压迫动眼神经1例)。结论单纯性动眼神经麻痹的病因多样,海绵窦区病变占大多数。MRI检查有助于明确动眼神经麻痹的病因。Objective To explore the etiopathogenisis of the isolate oculomotor nerve palsy with MRl. Design Retrospective case series. Participants One hundred and twenty-three patients with isolate oculcmotor nerve palsy. Methods MRI of 123 patients with isolate oculotomor nerve palsy were analyzed retrospectively. The MRI features of lesions were observed. Main Outcome Measures MRI findings. Results In 123 cases of isolate oculomotor nerve palsy, there were 87 cases （70.7%） with abnormal. In 87 cases with abnormalities, cavernous sinus lesions were found in 62 cases （71.2%） , including nonspecific inflammations in 45, aneurysms in 8, tumors in 6, carotid-cavernous fistulas in 2 and intracavernous internal carotid artery atherosclerosis in 1. There were 16 cases （18.4%） with brainstem lesions, including infarction in 15 and inflammations in 1. Five cases（5.7%） with cranio-orbital communicating lesions were found, including inflammations in 3 and tumors in 2. Lesions in or around the cisternal segment of the oculcmotor nerve were found in 4 cases, including tumors in 2 and inflammations in 2. Conclusion The MRI findings of oculomotor nerve palsy are various, however cavernous sinus lesions is popular. MRI is useful to find the causes of oculomotor nerve palsy and helpful to guide specific treatment.

关 键 词：动眼神经麻痹 磁共振成像 

分 类 号：R774.6[医药卫生—眼科]