摘要
目的探讨眼内硅油迁移的临床特征及影像学表现。方法回顾性分析2017年1月至2022年12月在浙江中医药大学附属第二医院行玻璃体切除伴硅油填充手术且经随访影像学检查确诊的18例硅油向后迁移患者的临床及影像资料,患者术后均行头颅CT平扫检查。收集患者硅油填充适应征、填充侧别、术前及术后眼压等一般资料,观察病侧眼内硅油迁移部位、形态、CT值及脑室积油的动态变化等影像特点。结果18例患者中,术后较术前视力减低1例,改善17例。眼内硅油迁移部位位于视神经乳头部1例,视神经15例,视交叉2例,侧脑室内1例。迁移硅油呈球状1例,类圆形15例,管状2例。影像上病灶均呈高密度灶,多数边界清楚,CT值范围54.89~89.23HU,平均70.95±8.18HU;患侧眼内硅油CT值范围62.12~102.44HU,平均74.51±11.37HU。其中1例患者在多次CT检查随访中,观察到右侧侧脑室前角硅油移至第四脑室,大小、形态未发生变化。结论头颅平扫CT是观察是否发生硅油迁移首选检查方法,放射科医生应熟悉其迁移路径及影像特点,避免误诊为脑室积血。术后多次随访或改变检查体位,有助于对疾病的精准诊断。
Objective To investigate silicone oil migration's clinical and imaging features.Methods The clinical and imaging data of 18 patients with posterior migration of silicone oil who underwent vitrectomy with silicone oil tendonectomy to the Second Affiliated Hospital of Zhejiang Chinese Medical University from January 2017 to December 2022 were retrospectively analyzed,and all patients underwent postoperative head CT scans.The general data of the patient such as indications for silicone oil filling,filling side,preoperative and postoperative intraocular pressure were collected,and the imaging features such as the site of intraocular silicone oil migration,morphology,CT values and dynamic changes of oil accumulation in the ventricle on the diseased side were observed.Results Among the 18 patients,postoperative visual acuity was decreased in 1 case and improved in 17 cases.Intraocular silicone oil migration was located in the optic nerve head in 1 case,the optic nerve in 15 cases,the optic chiasm in 2 cases,and the lateral ventricle in 1 case.Silicone oil migration was spherical in 1 case,oval in 15 cases,and tubular in 2 cases.All lesions showed high density,and most of them had clear boundaries.The CT value ranged from 54.89 to 89.23HU,with an average of 70.95±8.18HU.The CT value of silicone oil ranged from 62.12 to 102.44HU,with an average of 74.51±11.37HU.One patient was observed to have moved silicone oil from the anterior horn of the right lateral ventricle to the fourth ventricle with no change in size or morphology during multiple follow-up CT examinations.Conclusions Cranial plain CT is the preferred method to observe whether silicone oil migration occurs.Radiologists should be familiar with its migration path and image characteristics to avoid misdiagnosis as intraventricular hemorrhage.Repeated follow-up or changing the examination position after the operation is helpful for accurate diagnosis of the disease.
作者
陈瑶
樊树峰
CHEN Yao;FAN Shufeng(The Second Clinical School of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China;Department of Radiology,the Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310000,Zhejiang,China)
出处
《中国现代医生》
2023年第11期5-9,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2021KY839)。
关键词
硅油填充术
计算机体层摄影
脑室
迁移
Silicone oil tamponade
Computed tomography
Migration
Ventricle
