息肉样脉络膜血管病变患者脉络膜血管系统及涡静脉影像学表现分析  

Analysis of changes of choroidal vascular system and vortex vein related imaging findings in patients with polypoid choroidal vascular disease

作　　者：李青楠[1] 刘炯[1] 杨光[1] 李静[1] 吴怡 许兰芳[1] LI Qingnan;LIU Jiong;YANG Guang;LI Jing;WU Yi;XU Lanfang(Eepartment of Ophthalmology,Beijing Jishuitan Hospital,Beijing 100096,China)

机构地区：[1]北京积水潭医院眼科,北京100096

出　　处：《医学影像学杂志》2022年第12期2067-2070,共4页Journal of Medical Imaging

摘　　要：目的探讨息肉样脉络膜血管病变(polypoid choroidal vasculopathy,PCV)患者血流动力学改变。方法选取我院就诊的53例PCV患者(53只眼)作为观察组,另选取25例同期健康体检者(50只眼)作为对照组,所有观察对象均给予相关影响学检查,对比影像学表现。结果观察组在黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness,SFCT)、脉络膜血管分布指数(choroidal vascular distribution index,CVI)上显著高于对照组,在脉络膜毛细血管层密度(choroidal capillary layer density,CCVD)上显著低于对照组(P<0.05),观察对象眼动脉各项血流动力学参数无显著差异(P>0.05),观察组涡静脉血流速度、视网膜中央动脉及睫状后短动脉收缩期峰值流速(PSV)低于对照组,视网膜中央动脉阻力指数(RI)高于对照组(P<0.05),观察对象睫状后短动脉的PSV及涡静脉血流速度与SFCT、CVI呈负相关,与CCVD呈正相关,睫状后短动脉的舒张末期血流速度(EDV)与SFCT呈负相关。结论PCV具有脉络膜毛细血管收缩、脉络膜中层/大血管层增宽及脉络膜变厚特点,而这些特点与脉络膜血液回流障碍、血流速度降低、循环阻力增加有关。Objective To investigate the hemodynamic changes in patients with polypoid choroidal angiopathy(PCV).Methods 53 patients with PCV(53 eyes)admitted to our hospital were selected as the study group,and 25 healthy people(50 eyes)were selected as the reference group.All the subjects were given relevant impact tests and compared with the imaging performance.Results Subfoveal choroidal thickness(SFCT)and choroidal vascular distribution index(CVI)of the study group were significantly higher than those of the reference group,and the choroidal capillary layer density(CCVD)was significantly lower than that of the reference group(P<0.05).There was no significant difference in the hemodynamic parameters of the ophthalmic artery of the study group(P>0.05).The venous blood flow velocity,the central retinal artery and the PSV of the posterior ciliary short artery of the study group were lower than those of the reference group,the RI of the central retinal artery was higher than that of the reference group(P<0.05).The PSV of the posterior ciliary short artery and the blood flow velocity of the vortex vein were negatively correlated with SFCT and CVI,and positively correlated with CCVD.The EDV of the posterior ciliary short artery was negatively correlated with SFCT.Conclusion PCV has the characteristics of constriction of choroidal capillaries,widening of middle/large vascular layer of choroid and thickening of choroid,and these characteristics are related to the obstacle of choroidal blood return,decrease of blood flow velocity and increase of circulation resistance.

关 键 词：息肉样脉络膜血管病变 涡静脉 脉络膜 光学相干断层扫描血管成像 

分 类 号：R814.42[医药卫生—影像医学与核医学] R771[医药卫生—放射医学]