巩膜微小异物的超声生物显微镜诊断

Ultrasound biomicroscopic diagnosis of scleral foreign microbodies

目的探讨超声生物显微镜检测和定位巩膜微小异物的价值。方法对26例裂隙显微镜或和UBM检查发现，但薄层CT和常规B超检查无阳性特征的巩膜微小异物的临床和影像学特征进行回顾性分析。结果巩膜微小异物分为四类：第一类（10例）：大于0．2mm，不透明，和巩膜背景对比明显，常规裂隙显微镜检查容易发现，UBM检查阳性；第二类（8例）：小于0．2mm，不透明，和巩膜背景对比明显，常规裂隙显微镜检查发现，UBM无阳性特征；第三类（6例）：大于0．2mm，透明或半透明，和巩膜背景对比不明显，常规裂隙显微镜初步检查未发现，但UBM检查发现；第四类（2例）：小于0．2mm，透明或半透明异物，和巩膜背景对比不明显，常规裂隙显微镜检查难以发现，UBM检查阴性，高倍裂隙显微镜检查发现。结论UBM能发现薄层CT、常规B超等检查不能发现的巩膜0．2mm以上的微小异物，弥补常规裂隙显微镜检查不足，代替对巩膜异物的手术探查。

Objective To investigate the role of ultrasound biomicroscopy （UBM） in diagnosing scleml foreign microbodies （SFMBs）. Methods The characteristics of 26 cases of traumatic patients with SFMBs diagnosed by slit lamp microscope （SLM） or UBM were analyzed. Results SFMBs were divided into four categories. Class I （10 cases） was more than 0.2mm, opaque in most cases, diagnosed by SLM and UBM; Class Ⅱ（8 cases） was less than 0.2mm, opaque or translucent, diagnosed by SLM, but not by UBM; Class Ⅲ （6 cases） was more than 0.2mm, transparent or translucent, diagnosed by UBM, but not by conventional SLM; Class Ⅳ （2 cases） was less than 0.2mm, transparent or translucent, found by high-resolution SLM, but not by UBM and conventional SLM. Conclusions UBM is a valuable adjunct for diagnosing SFMBs which are more than 0.2mm, even substitute operative exploration.