B超检查眼球穿孔伤患者球内各种强回声的分析及鉴别

To analysis and identify various kinds of strong echo signal of ocular-perforating injury by B-scan ultrasound

目的:分析B超对眼球穿孔伤中出现的各种强回声信号的诊断价值。方法:对临床确诊为眼球穿孔伤患者,进行B超检查,观察晶状体、玻璃体腔及球壁、球后的影像学表现。结果:眼球穿孔伤经B超检查球内出现强回声的患者176例176眼中,玻璃体积血146例,晶状体脱位4例,球内异物(包含球壁异物)105例,玻璃体腔内气泡1例,视网膜脱离34例,脉络膜脱离23例,后巩膜破裂9例。每例患者都同时合并以上两种或两种以上体征,每例患者的B超均表现有强回声信号。对以上病例出现的各种强回声信号总结如下:(1)浓稠的玻璃体积血;(2)球内异物;(3)脱位的晶状体;(4)玻璃体腔内气泡。结论:眼球穿孔伤由于前房出血,白内障、玻璃体积血或因眼睑肿胀,患者不合作,使眼后段检查很难进行,B超给眼科医生提供了极大的帮助。B超对视网膜脱离、球内异物、后巩膜裂伤、出血性脉络膜脱离等都十分敏感,并有特异性的影像。复杂的眼球穿孔伤球内常会出现一些易混淆的强回声信号,B超检查可以对这些声像进行鉴别,这是其他检查方法难以替代的。

AIM： To analysis the diagnostic value of B-scan on various kinds of strong echo signal of ocular-perforating injury. METHODS：Totally 176 patients （176 eyes） with ocular-perforating injury underwent B - scan ultrasound examination. We observed the B-scan imaging findings of the lens, vitreous cavity, eyeball wall and retrobulbar space. RESULTS： All 176 patients （ 176 eyes ） underwent B-scan ultrasound examination had strong echo. Vitreous hemorrhage was found in 146 cases, dislocation of lens in 4 cases, intraocular foreign body in 105 cases, intravitreous bubble in 1 case, retinal detachment in 34 cases, choroidal detachment in 23 cases, posterior scleral rupture in 9 cases. Every patient had two or more signs above, and had strong echo signal. All kinds of strong echo signal of the cases were summarized as follows：thick vitreous hemorrhage; intraocular foreign body;dislocation of the lens;intravitreous bubble. CONCLUSION： Because of anterior chamber hemorrhage, cataract, vitreous hemorrhage, eyelid＆amp;nbsp;swelling and noncooperation of patients, we couldn＇t examine the posterior segment. So B-scan provides a great help to the ophthalmologist. It is very sensitive and has specific images on the detachment of retina, intraocular foreign body, posterior scleral laceration, hemorrhagic choroidal detachment. Complex perforating injury of eyeball often appears some confusing strong echo signals, but B- scan can identify those images. Thus, it is irreplaceable by other examinations.