分离性垂直斜视眼外肌磁共振成像的形态学研究  

Morphological study of extraocular muscles in dissociated vertical deviation by magnetic resonance imaging

作　　者：郝瑞 刘阳 张伟[1] 赵堪兴[1] Hao Rui;Liu Yang;Zhang Wei;Zhao Kanxing(Tianjin Eye Hospital,Nankai University Affiliated Eye Hospital,Clinical College of Ophthalmology,Tianjin Medical University,Tianjin Eye Institute,Tianjin Key Laboratory of Ophthalmology and Visual Science,Tianjin 300020,China)

机构地区：[1]天津市眼科医院、南开大学附属眼科医院、天津医科大学眼科临床学院、天津市眼科研究所、天津市眼科学与视觉科学重点实验室,天津300020

出　　处：《中华眼科杂志》2023年第3期202-206,共5页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金(81800861);天津市重点研发计划科技支撑重点项目(19YFCSY00990);天津市卫生健康科技基金面上项目(TJWJ2021MS041);天津市医学重点学科(专科)建设项目(TJYXZDXK-016A)。

摘　　要：目的探讨分离性垂直斜视(DVD)眼外直肌Pulley位置及肌肉体积的特点。方法横断面研究。收集2020年1至12月在天津市眼科医院确诊为分离性垂直斜视的患者9例,招募健康志愿者10名。采用MRI连续冠状扫描观察和计算患者和健康志愿者眼外4条直肌Pulley位置及肌肉体积的变化。根据检查结果分组:A组为双眼对称性DVD组,B组为非对称性DVD组,C组为健康志愿者组。将A组分为主视眼(A-D)和非主视眼(A-nD),B组分为显著DVD眼(B-s)和非显著DVD眼(B-m)进行分析,分别与C组眼外4条直肌和上斜肌体积进行比较。采用单因素方差分析和独立样本t检验进行统计学分析。结果A组患者5例(10只眼),男性2例,女性3例,年龄(22±4)岁;B组患者4例(8只眼),男性2例,女性2例,年龄(28±8)岁;C组患者10例(20只眼),男性4例,女性6例,年龄(25±6)岁;3组间年龄(F=0.45,P=0.648)和性别(χ^(2)=0.78;P=0.833)差异均无统计学意义。3组间眼外4条直肌Pulley位置的差异均无统计学意义(F内直肌=0.52,F外直肌=0.62,F上直肌=0.72,F下直肌=1.16;均P>0.05)。眼外肌4条直肌中,A组和B组内直肌[A-D、A-nD、B-s、B-m分别为(562.8±64.4)、(560.6±53.2)、(557.0±48.7)、(551.5±45.8)mm3]、外直肌[A-D、A-nD、B-s、B-m分别为(519.8±44.5)、(511.0±49.4)、(501.0±35.6)、(498.3±45.3)mm3]和上直肌[A-D、A-nD、B-s、B-m分别为(472.8±66.9)、(449.4±41.7)、(433.0±60.8)、(412.5±54.5)mm3]体积均大于C组[内直肌:(423.3±51.9)mm3,外直肌:(439.7±35.3)mm3,上直肌:(328.1±36.5)mm3],差异有统计学意义(均P<0.05);A-D和B-m下直肌体积与C组相比[A-D、B-m和C组分别为(453.8±46.8)、(463.0±16.6)和(380.4±59.7)mm3],差异有统计学意义(均P<0.05)。结论对称性和非对称性DVD患者眼外4条直肌Pulley位置基本正常,但内直肌、外直肌和上直肌体积大于健康人,而对称性DVD主视眼和非对称性DVD非显著DVD眼下直肌体积大于健康人。Objective To observe the changes of pulley locations and muscle volumes of extraocular rectus muscles in dissociated vertical deviation.Methods This was a cross-sectional study.Data was collected from January 2020 to December 2020 in Tianjin Eye Hospital.The pulley locations and muscle volumes of extraocular rectus muscles in DVD patients and healthy volunteers were observed and calculated by continuous coronal MRI scan.One-way ANOVA and independent sample T test were used for statistical analysis.According to the examination results,Groups were divided into A(symmetric DVD),B(asymmetric DVD)and C(healthy volunteers).Data of symmetric DVD patients were divided into dominant eye(A-D)and non-dominant eye(A-nD),while that of asymmetric DVD patients were divided into severe DVD(B-s)and mild DVD(B-m).Volume of 4 rectus muscles and superior oblique muscle were calculated and compared to Group C,respectively.Results Group A included 5 patients(10 eyes),2 males and 3 females,aged(22±4)years;Group B included 4 patients(8 eyes),2 males and 2 females,aged(28±8)years;Group C included 10 patients(20 eyes),including 4 males and 6 females,aged(25±6)years.There was no significant differences in age(F=0.45,P=0.648)or gender(χ^(2)=0.78;P=0.833)among the three groups.There was no significant difference in pulley locations of extraocular rectus muscles between the three groups(FMR=0.52,FLR=0.62,FSR=0.72,FIR=1.16;all P>0.05).Among the four exterocular rectus muscles,the muscle volume of MR[A-D:(562.8±64.4)mm3,A-nD:(560.6±53.2)mm3,B-s:(557.0±48.7)mm3,B-m:(551.5±45.8)mm3],LR[A-D:(519.8±44.5)mm3,A-nD:(511.0±49.4)mm3,B-s:(501.0±35.6)mm3,B-m:(498.3±45.3)mm3]and SR[A-D:(472.8±66.9)mm3,A-nD:(449.4±41.7)mm3,B-s:(433.0±60.8)mm3,B-m:(412.5±54.5)mm3]in group A and group B was higher than that in group C[MR:(423.3±51.9)mm3,LR:(439.7±35.3)mm3,SR:(328.1±36.5)mm3],and the difference was statistically significant(All P<0.05).The inferior rectus muscle volume of dominant eye in group A and mild DVD eye in group B was significantly

关 键 词：斜视 动眼肌 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R777.41[医药卫生—诊断学]