眼眶植物性异物伤影像学特点及分析  

Imaging features and clinical analysis of intraorbital organic foreign body

作　　者：刘娜[1] 刘宁姝 吴昊芊 张辰星[1] 秦伟[1] 

机构地区：[1]第三军医大学第一附属医院眼科,重庆400038

出　　处：《中国实用眼科杂志》2017年第2期193-196,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析眶内植物性异物伤病人的病史、临床表现、影像学资料，特别是MRI在诊断眼眶植物性异物中的表现，以增加对眼眶植物性异物伤诊断及治疗的认识。方法回顾性分析2006年1月至2016年1月在第三军医大学第一附属医院眼科诊治的眼眶植物性异物伤、并经手术证实的患者42例，病史采集、眼科专科检查、针对性予以眼眶CT及（或）MRI检查，手术治疗。结果10岁以下的患者占35．7％；有明确视力下降者占59．5％；瘘道与瘘管形成占晚期入院患者的57．7％、结膜息肉形成占30．8％。眼眶CT诊断急性期植物性异物的准确率为37．5％，中晚期为84．2％；眼眶MRI诊断中晚期植物性异物的准确率为93．8％，其特点为增强MRI时病灶中央无强化影（异物，不强化），周边明显强化，冠状位的典型表现为环状强化。结论正确而及时的诊断需结合患者的全部临床资料，有明确眼眶外伤史、或有瘘道与瘘管与结膜息肉等临床表现时，应进行影像学检查。眼眶MR／对眶内植物性异物，特别是非急性期眶内植物性异物的诊断有显著的优越性。Objective To analyze the patients＇ medical history, clinical manifestations, imaging data, in particular the MR/ appearances of orbital organic foreign bodies in order to enhance the di- agnosis and enrich its treatment knowledge. Methods A retrospective analysis of the 42 confirmed surgeries of orbital organic foreign body injuries from January 2006 to January 2016 in our hospital. The medical history, ophthalmological examination, respective orbital CT and / or MRI examinations, and surgical treatments were analyzed. Results Among the 42 patients, 35.7% patients were under 10 years of age; 59.5% patients had a clear vision loss; fistula / fistula formation accounted for 57.7% of non-emergency hospital patients, conjunctival polyp formation accounted for 30.8% of non-emergency hospital patients; for acute orbital organic foreign body, CT diagnosis of accurate rate was 37.5%, for advanced orbital organic foreign body, CT diagnosis of accurate rate was 84.2%; the accurate rate of orbital MRI diagnosis of orbital advanced organic foreign body was 93.8%, which was characterized by enhanced MRI lesions without central intensive enhancement （foreign body, not enhanced）, peripheral significantly enhanced, typical coronal manifestation was ring enhancement. Conclusions Correct and timely diagnosis requires a combination of all the clinical data of patients; when treating patients with history of orbital injuries, or with clinical manifestations of fistula / fistu- la / conjunctiva polyps, MR/ imagining should be carried out. Orbital MR/ of the intraorbital organ- ic foreign body, particularly comparing with diagnosis of non-acute intraorbital foreign body, has dem- onstrated significant advantages.

关 键 词：植物性异物 眼眶 外伤 计算机断层 磁共振成像 

分 类 号：R779.14[医药卫生—眼科]