外伤患者眼眶内侧壁解剖性凹陷与骨折的CT鉴别诊断

CT differential diagnosis of orbital medial wall anatomical depression and fracture in traumatic patients

目的探讨外伤患者眼眶内侧壁解剖性凹陷与骨折好发部位的CT征象,为鉴别诊断提供依据。方法选取外伤患者的头颅CT资料,检出眼眶内侧壁解剖性凹陷及眼眶骨折患者共161例,包括眶内壁解剖性凹陷138例、眶内壁骨折23例,对其好发部位、CT表现(骨质异常、邻近关系、间接征象)进行比较。结果解剖性凹陷好发于眼眶内侧壁中后部,骨折好发于前中部(P<0.05)。眼眶内侧壁解剖性凹陷的CT表现为骨质凹陷/曲度改变,但骨折的CT征象为骨质断裂,伴有眶内积气、软组织肿胀、眼肌或脂肪疝等。结论眼眶内侧壁解剖性凹陷与骨折的好发部位比较差异有统计学意义;二者CT征象的差异也较明显,可根据有无骨质断裂、眶内积气、软组织肿胀等进行鉴别,鉴别困难时需依靠临床表现、后期随访等。

Objective To investigate the common sites and CT features of orbital medial wall anatomical depression and fracture in patients with trauma,so as to provide morphological basis for differential diagnosis.Methods We retrospectively collected 161 patients with traumatic history performed CT examination,including 138 cases of orbital medial wall anatomical depression and 23 cases of orbital medial wall fracture and compared their common sites and CT signs(abnormal of bone,proximity relation and indirect signs).Results The anatomical depression of medial orbital wall mainly occured in the middle and posterior part,while fracture occured in the anterior and middle(P<0.05).CT findings of anatomical depression were bone sunken.The CT signs of fracture were bone breakage,accompanied by orbital gas accumulation,fat or orbital rectus hernia,etc.Conclusion There are significant differences between orbital medial wall anatomical depression and fracture of predilection sites and CT signs.If CT signs can not be identified,then clinical manifestations and follow-up must be relied.