MRI所见透明质酸相关眼动脉栓塞患者视神经表现与经导管眼动脉溶栓疗效的关系

Correlation between MRI characteristics of optic nerve and effectiveness of interventional therapy in patients with hyaluronic acid related ophthalmic artery embolism

目的观察MRI所见透明质酸(HA)面部美容填充相关眼动脉栓塞患者视神经表现与经导管眼动脉溶栓疗效的关系。方法回顾性分析60例HA相关眼动脉栓塞患者,根据视神经于弥散加权成像中可见高信号灶与否将其分为阳性组(n=39)和阴性组(n=21);于经导管眼动脉溶栓治疗后随访3个月,评价治疗效果及其影响因素。结果对60例均成功完成经导管眼动脉溶栓,19例治疗有效(含阳性组4例、阴性组15例)、41例无效(含阳性组35例、阴性组6例),阴性组疗效优于阳性组(P<0.01)。以25.5 h为中位时间间隔节点,介入治疗效果在间隔≤25.5 h(8例有效、22例无效)与>25.5 h患者(11例有效、19例无效)之间差异无统计学意义(P=0.58)。结论经导管眼动脉溶栓用于治疗MRI显示存在视神经缺血性损伤表现的HA面部美容填充相关眼动脉栓塞患者往往效果有限。

Objective To observe the correlations of optic nerve manifestations on MRI and effectiveness of transcatheter ophthalmic artery thrombolysis in patients with hyaluronic acid(HA)facial cosmetic filler-related ophthalmic artery embolism.Methods MRI data of 60 patients with HA-related ophthalmic artery embolism were retrospectively analyzed.According to the presence of high signal foci of the optic nerve or not on diffusion weighted imaging,the patients were divided into positive group(n=39)or negative group(n=21).Transcatheter ophthalmic artery thrombolysis was performed,the patients were followed up for 3 months,and the curative effect and relative impact factors were evaluated.Results Transcatheter ophthalmic artery thrombolysis was successful in all 60 cases,being effective in 19 cases(4 in positive group and 15 in negative group)but ineffective in 41 cases(35 in positive group and 6 in negative group).The curative effect for negative group was superior to that for positive group(P<0.01).Taken 25.5 h as the cut-off point for patient visit interval,no significant difference of the effectiveness of transcatheter ophthalmic artery thrombolysis was found between patients with visit interval≤25.5 h(8 cases effective,22 cases ineffective)and those>25.5 h(11 cases effective,19 cases ineffective)(P=0.58).Conclusion Among patients with HA facial cosmetic filler-related ophthalmic artery embolism,the curative effect of transcatheter ophthalmic artery thrombolysis was often limited in those with manifestations of optic nerve ischemic injury showed on MRI could reveal.