彩色多普勒超声在眼弓蛔虫病和少儿特发性后葡萄膜炎鉴别诊断中的应用  

Application of color Doppler ultrasound in the differential diagnosis of ocular toxocariasis and idiopathic posterior uveitis in children

作　　者：沈琳[1] 杨文利[1] 李栋军[1] 王子杨[1] 陈伟[1] 赵琦[1] 李逸丰[1] 崔蕊[1] 刘倩[1] Shen Lin;Yang Wenli;Li Dongjun;Wang Ziyang;Chen Wei;Zhao Qi;Li Yifeng;Cui Rui;Liu Qian(Beijing Tongren Eye Center,Beijing Tongren Hospitalaffiliated to Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心、北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《临床眼科杂志》2024年第5期393-396,共4页Journal of Clinical Ophthalmology

摘　　要：目的探讨彩色多普勒超声在眼弓蛔虫病和少儿特发性后葡萄膜炎鉴别诊断中的应用。方法回顾性临床研究。2015年1月至2017年12月就诊于首都医科大学附属北京同仁医院,18例(18只眼)临床确诊为眼弓蛔虫病和21例(29只眼)临床诊断为特发性葡萄膜炎(除外单纯前葡萄膜炎)患儿的眼部超声影像表现及病史资料。利用卡方检验,分析眼弓蛔虫病和少儿特发性后葡萄膜炎的特征性超声表现。结果眼弓蛔虫病超声中均可探及玻璃体内弱点状回声炎性混浊及玻璃体内条带状增生条索,8只眼(44.4%)可探及后极部球壁增生团块,10只眼(55.6%)可探及周边部球壁增生团块,17只眼(94.4%)可探及牵拉性视网膜脱离。少儿特发性后葡萄膜炎超声中均可探及玻璃体内弱点状炎性混浊,4只眼(13.8%)可探及玻璃体内条带状增生条索,12只眼(41.4%)可探及与视盘回声相延续的后极部球壁回声增厚伴低回声间隙。卡方检验结果,超声表现中玻璃体增生条索、球壁增生团块及牵拉性视网膜脱离支持OT的诊断(χ^(2)值分别为33.150、15.533、19.262和33.197,均P<0.01),玻璃体内弱点状回声及后极部球壁增厚伴低回声间隙支持少儿特发性后葡萄膜炎的诊断(χ^(2)值分别为32.785和10.002,均P<0.01)。结论彩色多普勒超声在眼弓蛔虫病和少儿特发性后葡萄膜炎鉴别诊断中有一定应用价值。Objective To investigate the application of color doppler ultrasound in the differential diagnosis of ocular toxocariasis(OT)and idiopathic posterior uveitis in children.Methods Retrospective clinical stucty Ultrasonographic findings and clinical dataof 18 cases(18 eyes)of toxoplasmosis and 21 cases(29 eyes)of idiopathic posterior uveitis diagnosed in our hospital from January 2015 to December 2017 were analyzed retrospectively.The Chi-square test was used to analyze the characteristic ultrasonographic manifestations of OT and idiopathic posterior uveitis in children.Results Vitreous inflammatory exudates and vitreous proliferous bands were detected in all eyes with OT.Proliferative masses were detected in 8 eyes(44.4%)in the posterior pole and in 10 eyes(55.6%)peripherally.Tractive retinal detachment was detected in 17 eyes(94.4%).In children with idiopathic posterior uveitis,vitreous inflammatory exudates were detected in all eyes.Vitreous proliferous bands were detected in 4 eyes(13.8%).Peripheral proliferative mass could be detected in 4 eyes(13.8%)and no-echo gap in the posterior pole ocular wall could be detected in 12 eyes(41.4%).The Chisquare test showed that vitreous proliferative bands,posterior or peripheral proliferative mass and tractive retinal detachment supported the diagnosis of OT(χ^(2) values were 33.150,15.533,9.262 and 33.197,respectively,all P<0.01),and noecho space in the posterior pole ocular wall supported the diagnosis of idiopathic posterior uveitis in children(χ^(2)values were 10.002,all P<0.01).Conclusions Ultrasound is of value in the diagnosis of both diseases.

关 键 词：超声 彩色多普勒 眼弓蛔虫病 少儿特发性后葡萄膜炎 

分 类 号：R445.1[医药卫生—影像医学与核医学] R531.8[医药卫生—诊断学] R773[医药卫生—临床医学]