眼眶爆裂性骨折X线平片、CT检查影像学表现及诊断价值分析  

X-ray and CT Findings and Diagnostic Value of Orbital Blowout Fracture

作　　者：龚雪[1] 王晓莉[1] 蔡方荣 GONG Xue;WANG Xiao-li;CAI Fang-rong(Department of Ophthalmology,People's Hospital of Jianyang City,Jianyang 641400,Sichuan Province,China)

机构地区：[1]简阳市人民医院眼科,四川简阳641400

出　　处：《中国CT和MRI杂志》2020年第11期159-161,共3页Chinese Journal of CT and MRI

基　　金：四川省科技支撑计划项目资助(编号:s2017048)。

摘　　要：目的探讨眼眶爆裂性骨折X线平片、CT表现及诊断价值。方法收集2018年1月至2018年12月于我院进行就诊治疗的48例眼眶爆裂性骨折患者资料,比较不同检查方法对骨折的诊断率,并总结其影像学特征。结果 CT检查对眼眶爆裂性骨折的诊断率显著高于X线平片(P<0.05);X线平片检查中检出的25例眶内骨折主要表现为患侧筛窦密度增高,合并眼眶内气肿4例;7例眶下壁骨折表现为上颌窦上壁不清楚,上颌窦上壁有半圆形高密度影突向窦腔,呈"泪滴样"表现。CT检出43例骨折患者在轴位均表现为内侧壁、下壁骨质连续性中断、粉碎;其中28例骨折其骨折断端成角或呈弧形向筛窦及上颌窦内突入。14例眶内侧壁骨折患者其骨折周围眼外肌增粗,且显示移位及嵌顿于骨折处;6例眶内下壁骨折患者可见眶内容物脱出,其通过骨折处疝入上颌窦内形成如"泪滴征"。在冠状为扫面显示6例眶下壁骨折并下榻,其中2例骨折患者骨折处有部分眶内脂肪及骨折碎片疝入上颌窦腔,3例伴有上颌窦腔积液。结论 X线平片操作简便、价格低廉,可将其作为眼眶爆裂性骨折检查的首选手段,但CT及多平面重建检查能对眼眶爆裂性骨折的临床诊断、治疗提供更多信息。Objective To explore the radiographic findings and diagnostic value of X-ray film,CT examination of orbital burst fracture.Methods We collected data of 48 patients with orbital burst fractures who were treated in our hospital from January 2018 to December 2018.We compared the diagnostic rates of different examination methods for fractures and summarized their imaging features.Results CT diagnosis of eyelid burst fractures was significantly higher than X-ray plain film(P<0.05);in the 25 cases of intraorbital fracture detected by X-ray plain film,the density of the side ethmoid sinus was increased,and 4 cases were complicated with intraorbital emphysema.The 7 cases of fractures of the inferior orbital wall showed unclear upper wall of maxillary sinus,and there were semicircular high-density shadows in the upper wall of maxillary sinus,presenting a"teardrop-like"appearance.All the 43 cases of fracture detected by CT presented fracture continuity and comminution in the medial wall and inferior wall.In 28 cases,the fracture ends were angular or curved into ethmoid sinus and maxillary sinus.14 patients with medial wall fractures of the orbit had thickened extraocular muscle around the fractures,and showed displacement and incarceration at the fracture site.In 6 patients with intraorbital inferior wall fracture,orbital contents were herniated into the maxillary sinus through the fracture,forming the"tear drop sign".The coronal scan showed 6 cases of fractures in the inferior orbital wall,among which 2 cases had partial intraorbital fat and fracture fragments herniated into the maxillary sinus cavity,and 3 cases were accompanied by maxillary sinus effusion.Conclusion X-ray plain film is easy to operate and cheap,so it can be used as the first choice for the examination of orbital blowout fracture.However,CT and multiplanar reconstruction technique can provide more information for the clinical diagnosis and treatment of orbital blowout fracture.

关 键 词：眼眶爆裂性骨折 X线平片 CT 影像学表现 

分 类 号：R816[医药卫生—放射医学]