CT对小儿白瞳症的诊断价值(附26例报告及文献复习)

The diagnostic value of CT for childhood leukocoria (a report of 26 cases with review of literature)

目的：探讨CT对小儿白瞳症的病因诊断价值。材料和方法：回顾性分析经手术病理或临床随访证实的白瞳症26例的CT表现，其中视网膜母细胞瘤(Rb)21例，Coats病4例，早产儿视网膜病变(ROP)1例。结果：23只眼Rb中22只眼内出现钙化，1例无钙化者年龄为6个月；2例视神经增粗。4例Coats病球内肿块无钙化，年龄均在6岁以上。1例ROP肿块内出血，无钙化。结论：CT表现与临床病史密切结合可提高小儿白瞳症病变的诊断价值。3岁以下儿童有钙化的眼内肿块高度提示Rb，6岁以上儿童眼内无钙化的肿块多提示Coats病，早产低体重儿尤其有吸氧史者的眼内肿块见于ROP。

Objective:To evaluate the diagnostic value of CT in childhood leukocoria.Materials and Methods:CT findings of 26 cases of pathologically-proved or clinically-proved leukocoria,including retinoblastoma(Rb,n=21),Coats'disease(n=4) and retinopathy of prematurity (ROP,n=1),were analyzed retrospectively.Results:Intraocular calcifications were detected in all but one in 23 eyes of retinoblastoma(22/23).None of four cases with Coats'disease in children older than six years of age had calcification.One case of ROP appeared as a noncalcified mass with hemorrhage.Conclusion:CT features combining with clinical data can improve the diagnostic rate in childhood leukocoria.Intraocular calcification in childhood,especially younger than three years of age,is highly suggestive of retinoblastoma.Noncalcified mass in older than six years of age suggests Coats'disease.A noncalcified mass in premature infants with low weight,especially with a history of therapy of supplemental oxygen,supports the diagnosis of ROP.