眼眶爆裂骨折的CT诊断

CT diagnosis of orbital blowout fracture

目的探讨眼眶爆裂骨折的CT表现及诊断方法。方法45例眼眶爆裂骨折病例均行常规眼眶轴位薄层扫描,部分病例加行冠状位薄层扫描。结果能直接显示骨折线12例,内直肌增粗34例,眼肌及眶内脂肪疝入副鼻窦35例,内直肌与眶内脂肪间隙变窄或消失34例,眶内及眼睑积气27例,副鼻窦积液或塌陷36例(含同一病例同时发生2组或2组以上副鼻窦积液,其中筛窦塌陷及积液32例,上颌窦积液3例,蝶窦积液3例,额窦积液2例),眶周软组织肿胀45例。结论CT能明确眼眶骨折的类型,显示眼眶爆裂骨折周围软组织及副鼻窦变化情况,是目前诊断眼眶爆裂骨折最有效的方法。

Objective To explore CT findings and diagnosis methods oforbital blowout fracture. Methods Axial thin slices CT scans on orbitsin 45 cases with orbital blowout fracture were performed,as well asadditional coronal thin slices CT scans in some of the cases. ResultsThe results revealed fracture lines in 12 cases,medio-rectus musclehypertrophy in 34 cases, hernia of ocular muscle ant orbital fat intoparnasal sinuses in 35 cases and narrowed or disappeared space betweenmedio-rectus muscle and orbital fat in 34 cases, pneumatosis of orbitand eyelid in 27 cases.Besides,there occurred 36 cases of hydrops orcollapse of paranasal sinus(some of the patients had 2 or more then 2hydroped sinuses.Hydrops occurred in ethmoid sinus in 32 cases,inmaxillary sinus in 3 cases, in sphenoidal sinus in 3 cases and in frontalsinus in 2 cases).Swelling of peri-orbit soft tissue were seen in 45 cases.Conclusion CT is an effective method to diagnose the fracture of orbitalblowout,showing the shape of orbital fracture and the change of softtissue and paranasal sinuses around the rupture of orbital fracture.