出血性视网膜脱离合并玻璃体积血的B超声像学特征及病因分析

Ultrasonographic features of hemorrhagic retinal detachment with vitreous hemorrhage and its etiological analysis

目的探讨出血性视网膜脱离的B超声像学特征及其病因特点。方法收集安徽医科大学附属省立医院2015年7月至2017年8月诊断为玻璃体积血并行玻璃体切割术病人334例,将术前眼科B超显示为出血性视网膜脱离与术中验证结果进行比对,分析其B超声像学特征及其临床特点。结果术前B超提示为出血性视网膜脱离病人为28例,经手术证实有22例,其中年龄相关性老年黄斑变性(Age-related macular degeneration,AMD) 5例,息肉样脉络膜血管病变(Polypoidal Choroidal Vasculopathy,PCV) 12例。主要超声特点是与视盘相连的视网膜条带状中强回声影,其下见扁平弧形回声隆起伴点状回声。超声检查诊断敏感性及特异度较高,分别为80.0%和96.2%。结论通过眼科B超的声像学特征来辅助诊断视网膜下出血,这对于临床诊断、治疗及术后转归预测有重大临床意义,其诊断的敏感性及特异度较高。

Objective To explore the B-ultrasonic features and etiological characteristics of hemorrhagic retinal detachment.Methods A total of 334 patients with vitreous hemorrhage who underwent vitrectomy in Anhui Provincial Hospital from July 2015 to August 2017 were enrolled in the study.The preoperative B-ultrasound results for hemorrhagic retinal detachment were compared with the results of intraoperative verification before the B-ultrasound sonographic features and clinical features were analyzed.Results Preoperative B-ultrasound results revealed 28 cases of hemorrhagic retinal detachment,22 cases of which were confirmed by surgery,including 5 cases of age-related macular degeneration(AMD)and 12 cases of polypoidal choroidal vasculopathy(PCV).The main ultrasound features were the moderately strong echoes of the retina strips connected to the optic disc,and the flat curved echoes with punctate echoes under it.The sensitivity and specificity of ultrasound examination were higher,which were 80.0%and 96.2%,respectively.Conclusion The sonographic features of ophthalmological B ultrasound are of great clinical significance in the diagnosis,treatment and postoperative outcome prediction of subretinal hemorrhage.The diagnostic sensitivity and specificity are high.