结节型后巩膜炎的超声影像学特征

Ultrasound imaging features of nodular posterior scleritis

目的探讨结节型后巩膜炎的超声影像学特征。方法对临床确诊为结节型后巩膜炎的13例患者（13眼）进行回顾性分析，记录其临床表现、眼底荧光造影、MRI表现，详细分析其彩色多普勒超声表现及超声造影表现。结果结节型后巩膜炎主要表现为眼球壁回声增厚，球壁可测及扁平隆起或半球形隆起实性病变，边界欠清晰，内回声均匀呈中等偏高回声，并且结节处球壁与脂肪垫之间的低回声间隙增宽。12例（92．3％）球壁回声增厚。7例（53．8％）呈扁平隆起实性病变，6例（46．2％）呈半球形隆起实性病变，其中2例（15．4％）内回声欠均匀，11例（84．6％）内回声均匀。12例（92．3％）结节处球壁与脂肪垫之间的低回声间隙增宽，4例（30．8％）有T形征，5例（38．4％）玻璃体内可测及点状弱回声，5例（38．4％）继发视网膜脱离，1例（7．6％）出现脉络膜脱离，1例（7．6％）测及视盘回声隆起。7例（53．8％）可测及血流信号，均未测及“挖空征”。5例给予超声造影检查，其中3例病变被造影剂填充，可见充盈缺损区，主要表现为病变内与对照造影剂同步增强、消退，且造影剂强度稍低于对照组织。结论结节型后巩膜炎有一定特征性超声表现，对该病的诊断有重要价值。

Objective To investigate the ultrasonic characteristics of nodular posterior scleritis. Methods Clinical data of 30 patients（30 eyes） with nodular posterior scleritis diagnosed in our hospital from January 2011 to December 2015 were analyzed retrospectively. The results of clinical manifestation, fundus fluorescence angiography, MRI and CDI were recorded and analyzed. Results The ultrasound showed thickened sclera and aflat-shaped or dome-shaped scleral mass with unclear margin and high internal echo. The low echo gap between the sclera and the anadesma was broadened. Twelve eyes（92.3%） of the 13 eyes had thickened sclera. Seven eyes （53.8%）were flat-shaped mass and six eyes（46.2%） were dome-shaped mass. Four eyes（30.8%） had ＂T＂-shaped sign. Five eyes（38.4%） had low echo dots in vitreous. Five eyes（38.4% ） had secondary retinal detachment. One eye（7.6%） had choroidal detachment. One eye （7.6%） had optic disc edema. Blood flow signals can be detected in seven eyes（53.8%）. Five cases were examined by contrast-enhanced ultrasonograthy,3 cases were filled by contrast agent, and the filling defect was found. The main manifestations were synchronous enhancement and regression, and the intensity was slightly lower than that in the control group. Conclusions There are certain ultrasonic features of nodular posterior scleritis. Ultrasonography is useful for the diagnosis of nodular posterior scleritis.