儿童眶下壁骨折的CT影像学特点

CT Characteristics of Pediatric Orbital Floor Fractures

目的探讨儿童眶下壁骨折的CT特点,提高对其影像学特点的认识。方法回顾性分析25例眶下壁骨折患儿的临床及CT表现。结果 25例患儿共计26眼眶下壁骨折,其中右侧15例,左侧11例。其中18眼(69.2%)单纯下壁骨折。眼眶爆裂骨折20眼(76.9%),直接骨折6眼(23.1%),18眼(69.2%)眶下管或(及)眶下沟受累,18眼(69.2%)眼眶内脂肪疝入上颌窦,12眼(46.2%)累及下直肌,其中8眼(66.7%)伴有下直肌疝,7眼(58.3%)伴有下直肌嵌顿。结论儿童眶下壁骨折多为爆裂骨折,易累及眶下管,易出现脂肪疝及下直肌疝,甚至嵌顿。外伤后应及时进行CT检查,有利于对眼外伤后眶壁骨折做出早期诊断,为临床治疗提供可靠依据。

Objective To evaluate the CT characteristics of pediatric orbital floor fractures. Methods The clinical data and CT images of orbital floor fractures in 25 children were retrospectively analyzed. Results Twenty six orbital floor fractures in 25 patients were included in our study, fifteen fractures occurred in right side, 11 in left side. Eighteen eyes （69%） were simple orbital floor fractures, the others were complicated with other orbital wall fractures. Twenty eyes （77%） were burst fractures,6 eyes （23 % ） were direct fractures, and 18 cases （ 70% ） were fractures involved infraorbital groove and infraorbital canal. 18（70% ） cases showed orbital fat herniation into the maxillary sinus. Inferior rectus muscles were involved in 12 eyes （46%）, of which, inferior rectus muscles herniated into the maxillary sinus in 8 （30%）cases, and inferior rectus muscle were showed incarceration in 7 （ 27% ） cases. Conclusion Pediatric orbital floor fractures are usual- ly burst fractures. The fractures usually involve the infraorbital groove and infraorbital canal, and cause orbital fat and infe- rior rectus muscle herniation, even incarceration. CT examination should be performed as early as possible after the eye trauma in order to make an early diagnosis.