外层渗出性视网膜病变的影像学特征与病理学对照  

Correlation of radiological charicteristics of Coats＇disease with pathology

作　　者：李洋[1] 郝大鹏[1] 周锐志[1] 王鹤翔[1] 刘吉华[1] 徐文坚[1] 

机构地区：[1]青岛大学附属医院放射科,山东青岛266003

出　　处：《实用放射学杂志》2016年第3期354-357,共4页Journal of Practical Radiology

摘　　要：目的分析外层渗出性视网膜病变（又称Coats病）的影像学特征，与病理组织学比较，探讨其影像表现的病理基础，提高诊断准确率。方法回顾性分析8例经手术病理证实的Coats病的CT、MRI和超声征象，荧光素眼底血管造影术（FFA）检查结果及病理资料。8例均行CT平扫、常规MRI和超声检查。结果8例均累及单侧眼球。CT表现：8例均表现为玻璃体内密度增高影，密度均匀、边界清楚，视网膜区增厚；5例前房深度变浅。1例玻璃体、晶状体内多发钙化灶。1例患侧眼球体积增大，1例患侧眼球萎缩，6例双侧眼球体积差别不明显；5例晶状体增厚、位置异常。MRI表现：8例玻璃体内等T1、等T2信号6例，短T1、长T2信号1例，长T1、长T2信号1例；3例患眼视网膜区见线样短T2信号；5例病变充满玻璃体，3例呈扁平的“V”形贴于视网膜区。超声表现：玻璃体内点状低回声6例；球壁隆起8例；视网膜脱离8例；球壁回声明显增强，提示球壁骨化1例；强回声钙化斑1例。FFA表现：视网膜毛细血管扩张8例，伴毛细血管无灌注区2例，散在栗状动脉瘤6例，视网膜新生血管1例。病理表现：镜下见视网膜毛细血管扩张伴大量泡沫状巨噬细胞和脂质沉积。结论Coats病具有典型的影像学征象，总结其CT、MRI和超声征象，结合FFA表现，与病理学相互对照有助于本病诊断。Objective To investigate the CT and MRI findings of Coats＇disease in comparison with pathology. Methods CT, MRI and ultrasonic featuresjFFA findings of eight patients of Coats＇ disease with histo-pathologically confirmed were analyzed retrospectively. CT scanning, routine MRI scanning and ultrasonic examination were performed in all eight patients. Results Unilateral eyeball was involved in all eight cases. On CT scanning, the density of the vitreous body was increased homogeneously which boundary was clear（n=8）. The retina was thick（n=8）. The anterior chamber depth was shallow（n= 5）. Multiple calcified loci occured in lens and vitreous body（ n=1）. The volume of affected eyeball increased（n=1）. The affected eyeball shrinked（n= 1）. The difference of volume of bilateral eyeball was not obvious（n=6）. Lens were thick and dislocation（n=5）. On MR1 scanning, the lesions in the vitreous body showed iso T1 and iso T2 signal （n= 6） , short T1 and long T2 signal（n= 1 ,long T1 and long T2 signal（n=1）. The retina showed short T2 signal（ n= 3）. The vitreous body was filled with lesions（n=5）. The lesions looked like‘V＇ sticked to retina（n=3）, On ultrasonic examination low echo was showed in the vitreous body（n=6）, the ball wall bulged（n= 8）, retinal detachment（n= 8）. The echo of the ball wall was obviously enhanced, which indicated ossification（ n= 1 ）. Strong echo calcified plaque was showed in one case. FFA showed retinal telangiectasia（ n=8）, retinal capillary zone（n= 2 ） , mutiple chestnut shaped aneurysms （n = 6 ） , retinal neovascularization （ n = 1 }. Pathological examination showed retinal telangiectasia with foam macrophages and lipid deposition. Conclusion Coats＇disease carries some typical CT and MRI fealures. To summarize the radiologic features, the findings of FFA and ultrasonic inspection are helpful to diagnosis.

关 键 词：外侧渗出性视网膜病变 计算机体层成像 磁共振成像 超声检查 病理学 

分 类 号：R774.1[医药卫生—眼科] R814.42[医药卫生—临床医学]