眼外伤的彩色多普勒超声、CT及CR检查诊断分析比较

Comparison of Color Doppler Ultrasound,CT and CR Inspection in the Diagnosis of Ocular Trauma

目的:探讨彩色多普勒超声(CDFI)、CT及CR三种影像检查对眼部异物、眼眶血肿的诊断价值。方法:对57例眼外伤的眼部彩超、CT及常规CR检查结果进行比较。结果:本组15例金属异物眼部彩超、常规CR及CT诊断均符合临床,眼部彩超及普通CR均有漏诊。本组25例非金属异物常规CR发现15例,眼部彩超发现14例,CT全部发现并提示异物位置。超声检查血肿22例声像图显示为边界清楚的异常回声占位病变;CDFI检查的情况:19例未发现血流信号,2例肿物边缘发现少许血流信号,1例间隔上有少许血流信号。CT检查:57例行CT扫描,血肿均表现为不同形状的高密度软组织影。CR检查57例中22例血肿均表现为局部高密度影。结论:①超声检查简便,无创;能发现大多数眼部异物,可作为眼部异物的筛查方法。CR是检查眼部异物的方法,其定位准确性不高,对植物性异物几乎不能诊断。CT不仅能检出细小的眼部异物,还分辨眼部异物位置。螺旋CT三维成像的运用,图像立体感强,定位更为准确,是眼部异物诊断的理想方法。三种方法有机合用可以明显提高检查的准确性。②超声检查可确定血肿的位置和形状,有助于血肿性质的判断,并可明确血肿的范围及其与视神经的关系。CT检查对眼眶占位病变的判断,具有一定的优势。

Objective： To study the color Doppler ultrasound, CT and CR diagnosis value for eye foreign body and orbital hematoma. Methods： The color Doppler ultrasound, CT and conventional CR inspection results of 57 cases of ocular trauma were compared. Results： The diagnosis of 15 cases of metal foreign body eye diagnosed by color Doppler ultrasound, CR, and CT were identified by surgery, while some cases were miss-diagnosed by eye color Doppler and conventional CR. Of the 25 cases of non-metal foreign bodies, 15 cases were found by conventional CR found in, 14 cases were discovered by color Doppler ultrasound, and all were found by CT. Conclusion： （1）Ultrasound examination is simple and non-invasive, can find most eye foreign bodies, and can be used for screening method for eye foreign body. CR is not good at locating the foreign bodies as well as finding the organic foreign body. CT, especially the spiral CT, can not only detect the mini eye foreign body, but also can locate the eye foreign body. Combination of the three methods could improve the diagnostic accuracy. （2）The ultrasound examination is helpful for the diagnosis of hematoma, while CT examination has advantages in differential diagnosis of orbital space-occupying lesions.