【摘要】 目的 通过CT断层解剖结构的分析，观察分析眼眶CT扫描成像在眼眶占位病变的诊断、治疗方法和手术路径中的重要作用与具有临床价值。方法 随机选择106例单侧眼眶病患者正常一侧眼眶CT解剖断层图像，分析各组织结构，揭示眼眶影像解剖特点。结果 眼眶水平CT断层扫描除对4条直肌、视神经、泪腺100%显示外，上斜肌、眼上静脉、眼动脉、滑车的显示率在近半数。另外，肌腱环、筛前筛后动脉、内外侧睫状后长动脉、视网膜中央动脉、眼下静脉、肌支动脉、眶上神经、泪囊、鼻泪管等也可显示。眼动脉自眶尖视神经外侧出现，与视神经并行约10mm，越过视神经到内侧，但个别自视神经内侧前行越至视神经外侧。此处手术操作易损伤眼动脉或视网膜中央动脉。下直肌显示形状为自眶后向前圆滑的椭圆形，易误诊为肿瘤。结论 CT扫描成像对眼眶解剖可提供可靠依据，但扫描技术参数、扫描基线及投照体位对显示率有影响。
He Yanjin，Liu Lin，Zhao Huifen，et al.
Department of Ophthalmology，The2nd Hospital of Tianjin Medical University，Tianjin300211.
【Abstract】 Objective By studying the anatomical structure that can be identified on computed tomography，to show the clinical value of the evaluation of orbital diseases，the choice of proper treatment and the surgical pathway.Methods The normal-side orbital computed tomography(CT)of106lateral orbital disease patients were recruited ranˉdomly，to analyse the anatomical structures，and unveil the orbital imaging anatomy character.Results Apart from100%of delineating of the four rectus muscles，optic nerve and lacrinal gland，CT was able to depict not only about50%of oblique muscle，superior ophthalmic vein，ophthalmic artery and the trochlea，but also musculotendinous ring，aterior ethˉmoidal artery，posterior ethmoidal artery，medial and lateral long posterior ciliar artery，central retinal artery，inferior ophˉthalmic vein，supraorbital nerve，lacrimal sac，nasolacimal duct etc.At the lateral side of the optic nerve，the ophthalmic artery was showed，and it run with the optic nerve approxmiately10mm，then crossed over the optic nerve to its medial side，where the operation objects to injure the ophthalmic artery or central retinal artery.But some crossed from the medial side to the lateral side of the optic nerve.The image of inferior rectus muscle seemed like smooth spheroid from backward to forward，which tended to misdiagnose as tumor.Conclusion Computed tomography can provide reliable evidence for orbital anotomy，while the showing rate can also be affected by scanning technical parameters，scanning level and plane.
Key words orbit computed tomography(CT) imaging anatomy
眼眶CT成像技术在眼眶病的诊断中居于很重要的位置，对眼眶占位性病变其显示率为100%，目前已成为常规检查方法之一。但由于眼眶组织结构的特点，检查时技术参数与头颅或全身尚有区别;另外眼眶解剖结构复杂，其断层影像解剖特点的揭示，对分析诊断眼眶病，以及选择正确的治疗方法和手术路径具有临床价值。故本文随机选择我院诊治的眼眶病患者的CT图像，106例正常一侧眼眶的影像表现，进行观察分析，现总结如下。
1 资料与方法
1.1 一般资料 从本院随机选择病例106例单侧眼眶病病例的正常一侧眼眶。男50例，女56例。左眶52只，右眶54只。年龄最小10岁，最大83岁，平均35岁。
1.2 CT参数 水平扫描，层厚3～5mm。电压120～140kV，多为130kV(57%)，电流65～300mA，半数为100mA(50%)，窗宽200～400。
1.3 观察眼眶结构 观察5～10个层面像，分为3部分，上部为眼球以上层面，约2层面;中部为眼球水平，约4～5层面;下部为眼球以下各层面，约2层面。
1.4 观察组织结构 (1)肌肉:包括内直肌、外直肌、上直肌、下直肌、上斜肌、下斜肌、提上睑肌、腱环;(2)血管:包括眼动脉、视网膜中央动脉、内外睫状后长动脉、筛前动脉、筛后动脉、眼上静脉、眼下静脉、涡静脉;(3)神经组织:视神经、眶上神经、鼻睫神经;(4)其它结构:滑车、泪囊、鼻泪管、睫状神经节。
[1] [2] 下一页 |
