彩色多普勒血流显像对永存原始玻璃体增生症诊断的敏感度和特异度  

Diagnostic sensitivity and specificity of color Doppler flow imaging for persistent hyperplastic primary vitreous

作　　者：陈伟[1] 李栋军[1] 王子杨[1] 赵琦[1] 李逸丰[1] 崔蕊[1] 沈琳[1] 杨文利[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,100730

出　　处：《中华眼底病杂志》2016年第3期296-299,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的 观察彩色多普勒血流显像（CDFI）对永存原始玻璃体增生症（PHPV）诊断的敏感度和特异度。方法 回顾性分析临床疑诊为并发PHPV的先天性白内障患儿71例93只眼的临床资料。其中，男性45例54只眼，女性26例39只眼。年龄1~24个月，平均年龄（7.6±4.3）个月。所有患眼均行CDFI检查，观察玻璃体内是否存在病理性条带状回声、条带状回声与眼球壁相连部位以及条带状回声上是否存在血流信号。CDFI检查后1周内，由两名经验丰富的眼底专科医师对其中64例患儿79只眼在全身麻醉状态下行晶状体切除联合玻璃体切割手术；对另外7例患儿14只眼在全身麻醉状态下进行散瞳眼底检查。根据手术中发现和眼底检查中所见的晶状体混浊、晶状体后囊增生、玻璃体增生及视网膜脱离位置等，结合PHPV临床诊断特点做出诊断。将上述诊断结果与CDFI检查结果进行比较分析，计算CDFI对PHPV诊断的敏感度及特异度。结果 手术及散瞳眼底检查结果显示，93只眼中发现玻璃体内异常85只眼，未发现玻璃内异常8只眼。玻璃体内异常85只眼中，诊断为PHPV 68只眼，家族性渗出性玻璃体视网膜病变（FEVR）16只眼，牵拉性视网膜脱离1只眼。手术及散瞳眼底检查发现玻璃体内异常的85只眼中，CDFI检查发现玻璃体内异常81只眼，敏感度为95.3%；玻璃体内未见异常回声4只眼，漏诊率为4.7%。手术及散瞳眼底检查未发现玻璃体内异常的8只眼，CDFI检查均在玻璃体内探查到与视盘或晶状体后相连的纤细弱条带状回声。手术或散瞳眼底检查诊断为PHPV的68只眼中，CDFI检查诊断相同59只眼， 敏感度为86.8%；手术或散瞳眼底检查未诊断为PHPV的25只眼中，CDFI检查亦排除PHPV诊断8只眼，特异度为32.0%。手术或散瞳眼底检查诊断为FEVR的16只眼及牵拉性视网膜脱离的1只眼，CDFI检查均诊断为PHPV，误诊率�Objective To observe the diagnostic sensitivity and specificity of color Doppler flow imaging （CDFI） for persistent hyperplastic primary vitreous （PHPV）. Methods The clinical data of 71 children （93 eyes） with congenital cataract which suspected of concurrent PHPV were retrospectively analyzed. The children included 45 males （54 eyes） and 26 females （39 eyes）, aged from 1 to 24 months, with an average age of （7.6±4.3） months. All eyes were examined by CDFI, and observe whether there was a pathological strip in the vitreous, the site of the connection between the strip echo and the wall of the eye and the signal of blood flow on the strip echo. Within 1 week after a CDFI examination under general anesthesia, 64 children （79 eyes） underwent lens excision combined with vitrectomy and the other 14 eyes of 7 children underwent mydriatic fundus examination by two experienced eye specialists. Combined with clinical features of PHPV, the diagnosis and differential diagnosis were made according to the clouding of the lens, posterior capsule proliferation, vitreous proliferation and retinal detachment position which were found during operation and fundus examination. Compare and analyze the CDFI examination results and the above diagnosis results, calculate the sensitivity and specificity of CDFI for PHPV. Results In surgery and mydriatic fundus examination results of 93 eyes, vitreous abnormal in 85 eyes, no significant changes were found in vitreous of the other 8 eyes. In 85 eyes of abnormal vitreous, 68 eyes were diagnosed as PHPV, 16 eyes were diagnosed as familial exudative vitreoretinopathy （FEVR）, and 1 eye was diagnosed as treactional retinal detachment. In 85 eyes of abnormal vitreous which were found by surgery and fundus examination, CDFI confirmed 81 eyes and its diagnostic sensitivity was 95.3%; the other 4 eyes were not found vitreous abnormality, and the missed diagnosis rate was 4.7%. Surgery and mydriatic fundus examination found no vitreous abnormal in 8 eyes, but CDFI ex

关 键 词：永存原始玻璃体增生症/诊断 超声检查 多普勒 彩色 

分 类 号：R776.4[医药卫生—眼科]