3D-FIESTA序列在儿童复杂性斜视中的应用价值

Study on congenital complex strabismus with 3D-fiesta sequences

目的探讨3D-Fiesta序列在儿童复杂性斜视中,对于相关眼运动神经及受累眼外肌异常的诊断价值。方法18例经临床诊断证实的儿童复杂性斜视患者,回顾性分析各眼运动神经及眼外肌的MR影像表现。结果 1)眼球后退综合征:11例共15只患眼,患侧外展神经脑池段缺如或发育不良,眼外肌形态正常;2)眼外肌纤维化综合征:3例共5只患眼,表现为动眼神经、外展神经脑池段异常纤细改变,多组眼外肌不同程度变细、变薄,以上直肌明显;3)先天性眼一面麻痹综合征:4例7只患眼,表现为外展神经、面神经脑池段纤细或缺如,患侧外直肌变薄、变细。结论 3D-Fiesta序列能够清晰显示眼运动神经及其支配的眼外肌异常,提供判断复杂性斜视病因的影像信息,具有重要的临床应用价值。

Objective To investigate the value of 3D-Fiesta sequences for showing ophthalmic motion nerves and extraocular muscles abnormalities in the complex strabismus of children. Methods Eighteen patients with complex strabismus underwent MRI examination on 3.0 T MR unit. Ophthalmic nerves to extraocular muscles were imaged and analyzed with 3D-Fiesta scanning sequences in all patients. Results Patients with duane syndrome （ 11 cases, 15 eyes） all exhibited absence or hypoplasia of abducens nerve （CN6） and there were no hypoplasia of EOMs. Patients with congenital fibrosis of EOMs （3 cases, 5 eyes） exhibited severe hypoplasia of CN3 and CN6, and EOMs appeared hypoplasia to a different degree, particularly severe for the superior rectus. Multiple nerves displayed aplasia in patients with Mobius syndrome （4 case, 7 eyes） and there were hypoplasia of the lateral rectus in two cases. Conclusion Using 3D-fiesta scanning sequences could directly demonstrate absence or hypoplasia of ophthalmic nerves and abnormalities of corresponding extraocular muscles, which indicates its important value of clinical application in congenital complex strabismus.