外伤性视神经损伤的CT后处理技术影像学特征及临床应用价值分析

Analysis on Imaging Features and Clinical Application Value of CT Post-processing Techniques for Traumatic Optic Neuropathy

目的旨在探讨外伤性视神经损伤的CT后处理技术影像学特征及临床应用价值。方法选取我院2017年3月-2018年9月收治的外伤性视神经损伤患者共56例为研究对象,56例患者均进行MSCT检查,收集56例患者临床资料及影像学资料,由两名放射科诊断医生采用双盲法进行阅片,观察冠状面、矢状面、轴位等显示状况,分析外伤性视神经损伤影像学特点,比较MSCT平扫及后处理技术对外伤性视神经损伤诊断的检出率。结果 MSCT平扫对外伤性视神经损伤的检出率为52.54%,后处理技术对外伤性视神经损伤的检出率为96.61%,后处理技术对外伤性视神经损伤的检出率明显高于MSCT平扫,差异有统计学差异(P<0.05);56例患者中,眼球损伤59眼,眼环不完整12眼,球内出血25眼,晶状体脱位8眼,晶状体缺如6眼,前房加深、视网膜剥离各6眼,眼球破裂2眼。眼内异物24枚,CT平扫图像主要表现为眼球体积缩小,多数患者可见眼球壁不规则,球内正常解剖结构紊乱;视神经密度增高,局部增粗,边缘模糊,弯曲变性,骨窗显示眶壁骨折。CT平扫冠状面、矢状面均可见视神经增粗,视神经垂直部位存在弯曲变形,局部密度增高,少数视神经管出现不同程度的狭窄。MPR图像可直观显示眼环的完整性,沿视神经走行的斜位重建能准确地观察视神经损伤的情况。结论 CT后处理技术可直观、立体且全面显示外伤性视神经损伤的影像学特征,可为临床治疗提供可靠的影像学依据。

Objective To investigate the imaging features and clinical application value of CT post-processing techniques for traumatic optic neuropathy.Methods A total of 56 patients with traumatic optic neuropathy admitted to our hospital from March 2017 to September 2018 were enrolled in the study.All patients underwent MSCT examination.The clinical data and imaging data of 56 patients were collected.Two diagnostic radiologists with high seniority used double-blind method to read the images,observe the coronal plane,sagittal plane,and axial plane,and analyze the imaging features of traumatic optic neuropathy,and compare the detection rate of MSCT plain and post-processing techniques for traumatic optic neuropathy.Results The detection rate of MSCT plain for traumatic optic neuropathy was 52.54%,and the detection rate of post-processing techniques for traumatic optic neuropathy was 96.61%.The detection rate of postprocessing techniques was significantly higher than that of MSCT.The difference was significant(P<0.05).Among the 56 patients,there were 59 eyes with damage of eyeball,12 eyes with incomplete deformation of ring plate,25 eyes with intraocular hemorrhage,8 eyes with dislocation of lens,6 eyes with absence of lens,6 eyes with deepened anterior chamber,6 eyes with retinal detachment and 2 eyes with rupture of eyeball.There were 24 foreign bodies in the eye.The image of CT scan mainly showed the volume of the eyeball was reduced.Most patients can be seen with irregular wall of eyeball,and the normal anatomical structure of the eyeball was disordered.The density of optic nerve increased and thickened partly,with blurred edges,bending and degeneration.The bone window shows fracture of orbital wall.CT scan of the coronal and sagittal planes showed thickening of the optic nerve.The vertical part of the optic nerve showed bending and deformation,local density increased,and a few optic canals showed varying degrees of stenosis.The MPR image visually showed the integrity of the eye ring,and the oblique reconstruction along the optic nerve can accurately observe the damage of the optic nerve.Conclusion CT post-processing techniques can visually,stereoscopically and comprehensively display the imaging features of traumatic optic neuropathy,which can improve reliable information of imaging for clinical treatment.