泪道阻塞性疾病患者的CT造影征象表现及价值分析

Analysis of CT Imaging Signs and Value in Patients with Lacrimal Duct Obstruction Diseases

目的探讨泪道阻塞性疾病患者CT造影征象表现及价值。方法选取因溢泪入院就诊的患者32例(64眼)作为研究对象,均行CT泪道造影检查。结果本组32例64只眼中,21只眼正常(32.81%),43只眼存在阻塞性泪道疾病(67.19%),其中6.98%泪总管阻塞,11.63%泪小管阻塞,81.39%鼻内管阻塞。35只眼鼻内管阻塞中,2.86%复发性泪囊炎,88.57%慢性内囊炎,8.57%泪囊囊肿。CT矢状位图像上,42.86%鼻内管上段阻塞,40.0%鼻内管中段阻塞,17.14%眼下段阻塞。21只眼正常,注入造影剂后泪小管、泪囊等均显影,且鼻腔内有造影剂;5只眼泪小管阻塞表现为下泪小管内处造影中断,泪囊、鼻内管内未见造影剂显影;3只眼泪总管显示结膜囊、泪小管可见显影,而泪囊、鼻内管内未见显影;35只眼鼻内管阻塞表现为泪小管、泪囊内可见显影,鼻内管造影中断。慢性内囊炎斜矢状位、轴位、斜冠状位的泪囊近似面积显著高于正常眼,差异显著(P<0.05)。结论 CT泪道造影可作为临床诊断泪道阻塞性疾病的重要影像学方法之一。

Objective To investigate CT imaging signs and value in patients with lacrimal duct obstruction diseases.Methods 32 patients （64 eyes） who were treated in the hospital because of epiphora were selected as the research objects. All the patients underwent CT angiography of lacrimal duct.Results Among the 32 cases （64 eyes）, 21 eyes were normal （32.81%） and 43 eyes with obstructive disease of the lacrimal duct （67.19%）, including 6.98% of general lacrimal duct obstruction, 11.63% of lacrimal canaliculus obstruction and 81.39% of nasal inner tube obstruction. Among the 35 eyes with nasal inner tube obstruction, there were 2.86% with recurrent dacryocystitis, 88.57% with chronic dacryocystitis and 8.57% with dacryocyst cyst. CT sagittal images showed that there were 42.86% of the nasal obstruction in the upper tube, 40.0% in middle section nd 17.14% in the hypomere of eyes. 21 eyes were normal. After injection of contrast media, the lacrimal canaliculus and lacrimal sac were developed and there was contrast agent in the nasal cavity. 5 eyes with lacrimal canaliculus obstruction manifested as imaging interruption in lower lacrimal canaliculus and there was no contrast agent in lacrimal sac and nasal cavity. The general lacrimal ducts of 3 eyes indicated development in conjunctival sac and lacrimal canaliculus and there was no development in lacrimal duct and nasal inner tube. 35 eyes with nasal inner tube obstruction manifested as development in lacrimal canaliculus and lacrimal sac and imaging interruption in nasal inner tube. The lacrimal sac approximate areas of oblique sagittal, axial and oblique coronal chronic dacryocystitis were significantly higher than those of normal eyes and the difference was significant （P 〈 0.05）. Conclusion CT dacryocystography can be used as one of the important imaging methods for clinical diagnosis of lacrimal duct obstruction diseases.