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目的总结眼外肌肥大的病因,并对影像学检查的诊断价值进行探讨。方法对249例CT或MRI检查显示眼外肌肥大的病例进行回顾性分析,并对病因进行分析和分类。结果炎症、血管畸形、肿瘤、感染、外伤等皆可是眼外肌肥大的病因。导致眼外肌肥大的疾病按发病率由高到低依次为甲状腺相关眼病、眼眶炎性假瘤、颈动脉海绵窦瘘、眶蜂窝织炎、转移性肿瘤、静脉曲张、眶骨骨折等。甲状腺相关眼病的眼外肌肥大以肌腹肥大为主,肌腱止点一般正常。炎性假瘤受累肌肉呈不规则增粗,边缘模糊,病变大多累及肌肉的止点。颈动脉海绵窦瘘通常为单眼眼外肌呈弥漫梭形肥厚。结论影像学检查包括CT和MRI扫描能够揭示眼外肌肥大的病因特征,并可作为鉴别诊断的依据。
Objective To summarize the etiology of extraocular muscle hypertrophy and to explore the diagnostic value of imaging examination. Methods A retrospective analysis of 249 cases of extraocular muscle hypertrophy by CT or MRI was performed. The etiology was analyzed and classified. Results Inflammation, vascular malformations, tumors, infections, trauma and so on are all the causes of extraocular muscle hypertrophy. The diseases that cause extraocular muscle hypertrophy are thyroid-associated ophthalmopathy, orbital inflammatory pseudotumor, carotid cavernous fistula, orbital cellulitis, metastatic tumor, varicose veins and orbital bone fractures according to the morbidity from high to low. Thyroid-related ophthalmia extraocular muscle hypertrophy mainly to abdominal muscle hypertrophy, tendon only normal. Inflammatory pseudotumor involvement of the muscle was irregular thickening, blurred edges, most lesions involving the muscles of the stop. Carotid cavernous fistula usually diffuse spindle hypertrophy of the extraocular muscle. Conclusion Radiographic examination, including CT and MRI scan, can reveal the etiological characteristics of extraocular muscle hypertrophy and can be used as the basis for differential diagnosis.