面部注射美容术致视力障碍眼部并发症的MRI表现  

MRI findings of ocular complications in patients with visual impairment after facial cosmetic injection

作　　者：杨淑辉 沈海洋 张鹏举 钟燕 邢新博 刘文潇 马丽颖 李天然 YANG Shuhui;SHEN Haiyang;ZHANG Pengju;ZHONG Yan;XING Xinbo;LIU Wenxiao;MA Liying;LI Tianran(Department of Diagnostic Radiology,the Fourth Medical Center,Chinese PLA General Hospital,Beijing 100048,China;Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100005,China;Department of Interventional Radiology,the Fourth Medical Center,Chinese PLA General Hospital,Beijing 100048,China)

机构地区：[1]中国人民解放军总医院第四医学中心放射诊断科,北京100048 [2]首都医科大学附属北京同仁医院放射科,北京100005 [3]中国人民解放军总医院第四医学中心介入科,北京100048

出　　处：《分子影像学杂志》2024年第6期587-592,共6页Journal of Molecular Imaging

摘　　要：目的总结面部美容注射术后致视力障碍患者眼部并发症的MRI影像表现。方法回顾性分析2015年12月~2023年5月因在外院行面部美容注射术后出现单眼视力急剧下降于解放军总医院第四医学中心就诊的73例患者的眼眶高分辨MRI表现。左眼视力障碍38例,右眼视力障碍35例。MRI的观察内容包括有无缺血性视神经病变、视网膜缺血损伤、眼外肌缺血水肿、上眼睑缺血水肿、球后渗出、眼球萎缩、眼球突出及MRI表现。结果73例(100%)均在MRI上出现缺血性视神经病变;38例表现为视神经眶内段局灶性病变,其中2例表现为多节段;35例累及视神经眶内段全程;73例在高清弥散Resolve序列上均表现为明显高信号,ADC图上信号减低;在T1WI上呈等信号,在T2WI上呈等或稍高信号。52例(71.2%)出现视网膜缺血损伤,在高清弥散Resolve序列上表现为视网膜弧形高信号影。45例(61.6%)出现眼外肌缺血水肿,表现为受累眼外肌增粗、肿胀,在T2WI上呈稍高信号。21例(28.8%)出现球后渗出,表现为在横轴位T2WI-FS上眼球后方肌锥内斑片状稍高信号影。33例(45.2%)出现上眼睑缺血水肿,表现为上眼睑肿胀,在横轴位T2WI-FS上呈稍高信号。7例(9.6%)出现眼球萎缩变形。4例(5.5%)出现眼球突出。结论面部注射美容术致视力障碍患者眼部并发症在MRI上可表现为急性缺血性视神经病变、视网膜缺血损伤、眼外肌缺血水肿、上眼睑缺血水肿、球后渗出、眼球萎缩及眼球突出。Objective To summarize the MRI findings of ocular complications in patients with visual impairment after facial cosmetic injection.Methods A retrospective analysis was performed on the orbital high-resolution MRI of 73 patients who came to the Fourth Medical Center of Chinese PLA General Hospital from December 2015 to May 2023 due to the sharp decline in monocular vision after facial cosmetic injection in other hospitals,including 38 cases of visual impairment in left eye and 35 cases of visual impairment in right eye.Observation contents of MRI included whether there were ischemic optic neuropathy,retinal ischemic injury,extraocular muscle ischemic edema,eyelid ischemic edema,retrobulbar effusion,eyeball atrophy,exophthalmos or not and MRI findings.Results All 73 cases(100%)showed ischemic optic neuropathy on MRI.Focal lesions of intraorbital segment of optic nerve were found in 38 cases,of which 2 cases were multisegmental.In 35 cases,the total intraorbital segment of optic nerve were involved.All 73 cases showed significantly high signal intensity on the high-resolution diffuse Resolve sequence and decreased signal on ADC map,with iso-signal intensity on T1WI,iso-signal or slight hyper-signal intensity on T2WI.Retinal ischemic injury occurred in 52 cases(71.2%),which showed retinal arc-shaped hyper-signal intensity on the high-resolution diffuse Resolve sequence.In 45 cases(61.6%),ischemic edema of extraocular muscles were observed,which were characterized by thickening and swelling of the involved extraocular muscles,and slight hyper-signal intensity on T2WI.Retrobulbar effusion was found in 21 cases(28.8%),which was manifested as patchy slightly hyper-signal intensity in the muscle cone behind the eyeball on the axial T2WI-FS sequence.33 cases(45.2%)developed upper eyelid ischemic edema,which was characterized by upper eyelid swelling and slightly elevated signal intensity on axial T2WI-FS.Eyeball atrophy and deformation occurred in 7 cases(9.6%).Exophthalmos occurred in 4 cases(5.5%).Conclusion Ocular compl

关 键 词：面部注射美容术 视力障碍 磁共振成像 

分 类 号：R62[医药卫生—整形外科] R771.3[医药卫生—外科学] R445.2[医药卫生—临床医学]