螺旋CT在眼爆炸伤中的应用价值

Application value of spiral CT in explosion injury of eyes

目的:探讨螺旋CT(Sp iral CT,SCT)在眼爆炸伤中对眼球内外的损伤及异物诊断中的应用价值。方法:68例(128眼)爆炸伤患者。SCT常规轴位3mm扫描,其中20例加冠扫,44例加冠状和/或矢状重建,用骨窗和软组织条件分析眼眶骨质和眼球结构,手术64例。结果:眼球破裂伤中眼环一处或多处断裂54只;晶状体膨大密度减低7只,晶状体脱落7只,眼环增厚16只;眼球增大3只,缩小13只;前房加深12只,玻璃体出血13只,视网膜脱离3只;眼部高密度异物81枚。球外损伤眼眶骨折18只,眼肌增厚7只,视神经损伤4只。将眼球损伤的范围和程度SCT表现,结合临床处理将眼球破裂分轻度、中度、重度三型。结论:SCT轴位加冠位及重建技术能明确眼球损伤及眼眶骨折的范围和程度,是眼爆炸伤中最有效的诊断方法。

Objective： To study the application value of Spiral CT（SCT） in explosion injury of eyes , Methods： SCT had examined 68 patients with explosion injury of eyes , Axial plane scanning was done with 3 mm slice and 512 ＊ 512 matrix . Bone and soft tissue conditions were adjusted to analyze the bone and global structures and additional to coronal plane scanning in 20 cases, coronal and all sajittal plane reconstructed images were performed in 44 cases. 64 cases were underwent operation. Results： SCT showed that the rupture of eye circle at one point and multiple points were seen in 54 eyes （ 42% ）, Len enlarged and Len density decreased in 7 （ 5% ）, eye circle thickened in 16 eyes （ 13% ） , eye -ball enlarged in 3 （ 2% ） and contracted in 13 （ 10% ） anterior chambers deepened in 12 （ 9% ） , intraglobe hemorrhage in 13 （ 10% ）, retinal detachment in 3 （ 2% ） , orbital fracture in 18 （ 14% ） , extra - ocular muscles thickened in 7 （ 5% ） , optic nerve injured in 4 （ 3% ） . We classified the rupture global into 3 types. Conclusion： Transverse and coronal plane scanning of SCT have an important value in diagnosis of explosion injury of eyes and orbital fracture and is also an effective method for diagnosing explosion injury of eyes .