100例眼内异物影像学检查分析

Imaging Diagnosis of 100 Patients with Intraocular Foreign Bodies

目的评价X线、CT、磁共振成像(MRI)在眼内异物诊断中的应用价值。方法回顾性分析2016年2月至2018年2月绵阳万江眼科医院收治的100例眼内异物患者的临床资料,分析患者行X线、CT或MRI影像学检查后眼内异物的检出情况。结果 26例患者经X线正、侧位拍片检查,均显示眶内有高密度异物影,检出率为100. 0%,眼内异物所处位置以玻璃体为主,其次为眼球壁、眼前段、眼球后,但不易显示并发症。74例接受CT检查的患者中57例表现为高密度伪影、10例高密度无伪影、7例低密度影,低密度影中有3例边界不清,加做MRI,最终均证实为非金属异物,其中包括2例木质异物、1例塑料异物。眼内异物的CT检出率为100. 0%,同时发现晶状体混浊或脱位、玻璃体混浊、眼球壁裂伤、眼球变形等眼内并发症。结论 X线、CT与MRI应用于眼内异物的诊断均具有较高的检出率,其中CT检查对眼内异物的定位、定性以及并发症的诊断具有较高价值,可作为主要检查手段;X线可作为初步筛查手段; MRI仅限于高度怀疑低密度木质或塑料异物损伤时的检查手段。

Objective To evaluate the role of imaging examination such as X-ray,CT scan or magnetic resonance imaging （MRI） in the diagnosis of intraocular foreign bodies（IOFB）. Methods A total of 100 patients with IOFB undergoing X-ray,CT scan or MRI examination in Mianyang Wanjiang Eye Hospital from Feb. 2016 to Feb. 2018 were retrospectively analyzed. Results All of the 26 patients who underwent frontal and lateral X-ray examination showed high density shadows indicating IOFB,forming a detection rate of 100.0%.The IOFB were mainly located at glass body,followed by eyeball wall,anterior segment,posterior segment,but complications were not easily detected.74 patients underwent CT scan,among which 57 cases had high density artefact,10 had high density without artefact and 7 showed low density shadows,including 3 cases with unclear boundary, and all of them were confirmed as nonmetallic foreign bodies by MRI, including 2 cases of woody foreign bodies and 1 case of plastic foreign body.The CT detection rate of IOFB was 100.0%.At the same time,intraocular complications such as lens opacity or dislocation,vitreous opacity,ocular wall laceration and deformity were detected. Conclusion X-ray,CT and MRI have a high detection rate in the diagnosis of intraocular foreign bodies.CT examination has a high value in the localization,characterization and diagnosis of complications of IOFB,and can be used as the main means of examination;X-ray can be used as a preliminary screening method;MRI is limited to highly suspected injury of low-density wood or plastic foreign bodies.