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目的探讨三种影像检查对眼部异物的诊断价值。方法对经B超、常规X线及CT检查的影像资料与临床证实的20例眼部异物进行系统分析,并对其影像检查方法作比较。结果 (1)2例小至12mm非金属异物(植物类)常规X线未发现,B超发现1例,只有CT才发现并作出诊断,其余18例异物(包括金属及非金属类)B超、常规X线及CT诊断均符合临床。(2)20例眼部异物患者中只有CT提示异物位置:眶内壁与眼球之间非金属异物8例(其中2例为碎玻璃,1例单眼单发,1例单眼多发;6例为碎石,4例单眼单发,2例双眼多发)占40%,球壁2例(1例为牙签残留,1例为木块,均为单眼单发,占10%);球内10例(,其中4例为单眼多发,3例为双眼多发,3例为单眼单发)占50%,但B超及普通X线均未能作定位诊断。结论 (1)超声检查是一种简便,无创的检查手段,且能发现大多数眼部异物,但不能进行准确定位,也难识别眶内小的非金属异物,可作为眼部异物的的筛查方法。(2)X线平片是检查眼部异物的传统方法,但因其定位繁锁且准确性不高,特别是对植物性异物几乎不能作出诊断,已逐渐被CT及MR I等影像检查方法所取代。(3)CT不仅能检出小至12mm的眼部异物,还分辨眼部异物位于球内、球壁或眶内。特别是螺旋CT三维成像的运用,图像立体感强,定位更为准确,是眼部异物诊断的的理想方法。
Objective To investigate the diagnostic value of three kinds of imaging in the diagnosis of ocular foreign bodies. Methods 20 cases of ocular foreign body confirmed by B-ultrasound, routine X-ray and CT were systematically analyzed and their imaging methods were compared. Results (1) No X-ray was found in 2 cases of non-metallic foreign bodies (plants) as small as 12mm. One case was found by B-mode ultrasound. Only CT was found and diagnosed. The other 18 cases of foreign bodies (including metal and nonmetal) , Conventional X-ray and CT diagnosis are in line with clinical. (2) Among the 20 patients with ocular foreign bodies, only CT showed the location of foreign body: 8 cases of non-metallic foreign bodies between the orbital wall and the eyeball (2 cases were broken glass, 1 case was monocular, 1 case was monocular; 6 cases was broken Stone, 4 cases of monocular solitary hair, 2 cases of multiple eyes) accounted for 40%, 2 cases of ball wall (1 case of toothpick residue, 1 case of wood, are monocular, accounting for 10% , Of which 4 cases were monocular, 3 cases were multiple eyes, 3 cases monocular) accounted for 50%, but B ultrasound and X-ray were not for diagnosis. Conclusion (1) Ultrasonography is a simple and noninvasive means of examination, and can find most of the eye foreign body, but can not be accurately positioned, it is difficult to identify small orbital non-metallic foreign body, can be used as the screening of foreign bodies of the eye Check method. (2) X-ray film is the traditional method of examining the eye foreign body, but because of its location and complexity and accuracy is not high, especially for plant foreign body almost can not make a diagnosis, has been gradually CT and MR I and other imaging methods Replaced. (3) CT can not only detect as small as 12mm eye foreign body, but also identify the eye foreign body located in the ball, ball wall or orbital. Especially the use of spiral CT three-dimensional imaging, strong sense of three-dimensional image, positioning more accurate, is the ideal method of diagnosis of foreign bodies in the eye.