应用3D-MRI成像技术重建高度近视眼球形态  

Reconstruct the high myopic eye modules with 3D-MRI imaging technology

作　　者：施靖容 何玉萍[1] 赵婷婷[1] 陈秋莹[1] 华怡红 胡运胜[2] 李念云 张琳[2] 张贵祥[2] 樊莹[1] 

机构地区：[1]上海交通大学附属第一人民医院眼科,200080 [2]上海交通大学附属第一人民医院放射科,200080

出　　处：《中华眼视光学与视觉科学杂志》2016年第5期269-274,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的 利用3D-MRI眼球建模技术探讨高度近视眼的MRI影像表现、形态特征,并与其他影像方法比较,评估其临床价值.方法 横断面研究.65例（124眼）高度近视患者（球镜度高于-6.00 D,且眼轴长度≥26 mm）进行眼部常规临床检查、眼眶磁共振检查,其中40例（80眼）进行眼部B超检查.磁共振图像经处理为眼球模型.按年龄分为＜50岁组和≥50岁组.按球镜度分为：①-6.00～-12.00 D组,②-12.25～-18.00 D组,③-18.25～-24.00 D组.按眼轴分为：①26.00～28.00 mm组,②28.01～30.00 mm组,③30.01～32.00 mm组,④＞32.00 mm组.MRI与B超对于后巩膜葡萄肿的诊断准确率比较采用McNemar检验,不同组别中眼球类型的分布差异采用卡方检验.结果 B超检出后巩膜葡萄肿的诊断准确率为70％,MRI检出后巩膜葡萄肿的诊断准确率为100％,差异有统计学意义（P＜0.05）.高度近视眼球形态可分为球型、锥型、碗型、柱型4种类型,碗型、锥型视为后巩膜葡萄肿存在.而4种眼球类型的分布在不同年龄组（x2=57.19,P＜0.05）、不同眼轴组（x2=87.36,P＜0.05）中的差异有统计学意义,在不同球镜度组（x2=67.94,P＞0.05）中的差异没有统计学意义.部分病例于MRI眼球模型上可见不规则隆起与凹陷,但B超不能精确显示.结论 3D-MRI眼球建模能清晰显示高度近视眼球形态与后巩膜葡萄肿的位置及特征,在眼科影像检查手段中诊断准确率高于B超检查,可作为高度近视眼科检查的新手段.Objective Analyze the shapes and features of high myopic eyes by 3D-MRI exanmination.To investigate 3D-MRI exanmination methods and imaging manifestations of high myopic eyes,and to evaluate its clinical values when comparing with other diagnostic imaging facilities.Methods 65 cases （124 eyes） of high myopic （the spherical diopter was equal or less than-6.00 diopter,and the eye axial length was equal or more than 26 mm） accepted the routine ophthalmologic examination and orbit MRI examination,among which,40 cases （80 eyes） had ophthalmic B-type ultrasound exanmination.The MRI imaging were processed into 3D models.Patients were divided into groups by age ①〈50 years,②≥50 years）,spherical diopter ①-6.00 D～-12.00 D,②-12.25 D～ -18.00 D,③-18.25 D～-24.00 D）,and eye axial length ①26.00 mm～28.00 mm,②28.01 mm～ 30.00 mm,③30.01 mm～32.0 mm,④〉32.00 mm）.The diagnostic accuracy of MRI examination and ophthalmic B-type ultrasound exanmination were analyzed by McNemar test,the correlation between eye shapes and case data were analyzed by chi square test.Results The diagnostic accuracy of the posterior staphyloma detected by ophthalmic B-type ultrasound exanmination was 70%,and was 100% by MRI examination,the positive rate of posterior staphyloma detected by MRI had significant difference （P〈0.05） at the level of α=0.05 compared with those by ophthalmic B-type ultrasound.The shape of high myopia eyeball can be divided into four types：spherical,conical,bowl and column.The distribution of the four types of high myopic eye in the age grous and eye axial group had significant difference （P〈0.05）,and had no significant difference in the spherical diopter group.In some cases,irregular uplift and depression can be seen on the 3D-MRI model,but can not be accurately displayed in the ophthalmic B-type ultrasound exanmination.Conclusion 3D-MRI model can demonstrate high myopia eyeball shapes and the location and characteristics of posterior staphyloma.It has a higher diagnos

关 键 词：近视 退行性 超声检查 磁共振成像 后巩膜葡萄肿 

分 类 号：R778.11[医药卫生—眼科]