Growth of the fetal lens and orbit.

OBJECTIVES: To present normal lens and orbital measurement ranges by gestational age. METHODS: Three hundred and thirty-five women with uneventful pregnancies were evaluated from the 15th to the 40th week of gestation. Lens and orbital measurements were added to routine biometric measurements for normal fetuses. RESULTS: A strong linear correlation was observed between gestational age (GA) and lens diameter (R(2)=0.89; P<0.0001), circumference (R(2)=0.89; P<0.0001), and surface (R(2)=0.90; P<0.0001). A linear correlation was also found between GA and orbital diameter (R(2)=0.92; P<0.0001), circumference (R(2)=0.92; P<0.0001) and surface (R(2)=0.95; P<0.0001). A linear growth function was observed between biparietal diameter and both lens diameter (R(2)=0.90; P<0.0001) and orbital diameter (R(2)=0.94; P<0.0001). CONCLUSION: Lens and orbital measurements provide normative data for fetal growth and development. These data may be also helpful in detecting fetal ocular anomalies.     

The steroid effect on the blood-ocular barrier change induced by triolein emulsion as seen on contrast-enhanced MR images.

OBJECTIVE: The purpose of this study is to evaluate the effect of dexamethasone on the damaged blood-ocular barrier caused by triolein emulsion, using contrast-enhanced MR imaging. MATERIALS AND METHODS: An emulsion of 0.1-mL triolein in 20 mL of saline was infused into the carotid arteries of 32 cats, 12 cats were placed in the treatment group and 18 cats were placed in the Control group. Thirty minutes after the infusion of triolein emulsion, a set of orbital pre- and post-contrast T1-weighted MR images (T1WIs) were obtained. Infusion of 10 mg/kg dexamethasone into the ipsilateral carotid artery of each of the cats in the treatment group cats and 20 mL saline in each of the cats in the control group was given. A second set of pre- and post-contrast orbital T1WIs were obtained three hours following triolein emulsion infusion. Qualitative analysis was performed for the the anterior chamber (AC), the posterior chamber (PC), and in the vitreous humor of the ipsilateral and contralateral eyes. The signal intensity ratios of the ipsilateral eye over the contralateral eye were quantitatively evaluated in the three ocular chambers on the first and second set of T1WIs, and were then statistically compared. RESULTS: Qualitatively, the AC, the PC or the vitreous did not show immediate contrast enhancement on the first and the second set of post-contrast T1WIs. However, the AC and the PC showed delayed contrast enhancement for both groups of cats on the second pre-contrast T1WIs. No enhancement or minimally delayed enhancement was seen for the vitreous humor. Quantitatively, the signal intensity ratios in the PC of the treatment group of cats were statistically lower than the ratios of the control group of cats for the second set of T1WIs (p = 0.037). The AC and vitreous showed no statistically significant difference between the feline treatment group and control group (p > 0.05). CONCLUSION: Contrast-enhanced MR images revealed increased vascular permeability in the PC of the eye after infusion of triolein emulsion. Dexamethasone seems to decrease the breakdown of the blood-aqueous barrier in the PC.     

Graves眼病眶部生长抑素受体显像研究

目的用99Tcm-奥曲肽(octreotide)SPECT眼眶显像评价Graves眼病活动度和预测免疫抑制疗效。方法Graves眼病患者39例,静脉注射925MBq99Tcmoctreotide后3h进行SPECT眼眶显像,利用感兴趣区技术,计算双侧眼眶(O)枕叶(OC)放射性比值。然后所有患者接受甲基强的松龙冲击治疗,计算治疗前和治疗1个月时的眼病指数(GOI)和临床活动度评分(CAS)。结果有效组34例,OOC比值为1.76±0.17;无效组5例,OOC比值为1.26±0.19(P<0.001)。OOC比值与治疗前CAS呈正相关(r=0.47,P<0.001),与治疗前后眼病指数差值(疗效)呈正相关(r=0.55,P<0.001)。OOC比值接受器工作特性(ROC)曲线下面积为0.971,当OOC比值取1.37时,阳性预测值为97%,阴性预测值为80%。结论OOC比值可反映Graves眼病患者眼病活动度和预测其免疫抑制疗效。     

Peripheral findings in MR using surface coil

Incidental peripheral lesions found during neuroradiological MR examinations with surface coils are reviewed. These include intracranial metastases during orbital examinations, cerebellar and thyroid lesions during cervical spine examinations, and dissecting and saccular abdominal aneurysms, as well as renal and intrapelvic abnormalities during lumbar spine examinations. Because of the reduced field-of-view and rapid signal drop-off in deeper portions of the body when examinations are performed with surface coils, peripheral and deep regions also need careful attention during routine evaluation.     

原发眼眶静脉曲张的彩色多普勒超声检查

目的探讨原发性眼眶静脉曲张患者的临床及彩色多普勒超声表现。方法对68例原发眼眶静脉曲张患者的患眼及健眼先行二维超声对照检查,初步确定眼眶内病变的位置、形状和内回声。再切换至彩色多普勒状态,在颈静脉加压和颈静脉压力解除过程中分别观察病变内的彩色多普勒血流变化情况,并对血流信号行脉冲多普勒频谱检查。结果眼眶静脉曲张具有体位性眼球突出特征,彩色多普勒超声检查具有特异性表现,平卧时正常,压迫颈内静脉后眶内出现囊性低或无回声区,并可查见导流静脉位置,对手术具有指导意义。结论彩色多普勒超声具有操作简便、无创、动态下观察、显示病变内血流情况等特点,对于眼眶静脉曲张的诊断和治疗具有指导意义。     

眼部病变的MRI表现

主要阐述了视神经，眼球内和眶内病变的ＭＲＩ表现，并简要评价了ＭＲＩ、ＣＴ和Ｂ超显示各种病变的优缺点以及各种影像检查综合诊断的价值。     

应用标准化A型超声诊断眼眶肿瘤

目的探讨标准化A型超声在眼眶肿瘤诊断中的应用价值.方法应用标准化A型超声对72例眼眶肿瘤,包括海绵状血管瘤、泪腺多形性腺瘤、泪腺腺样囊性癌、神经鞘瘤、血管外皮瘤、黏液囊肿和横纹肌肉瘤等病变进行检查,分析并总结图像特征,测量平均内反射百分比(Q-I值),并经病理结果验证.结果标准化A型超声通过病变反射波峰的高低、内部结构是否规则、声衰减程度等提示病变性质.每种肿瘤有独特的图像表现,入、出反射波峰间的Q-I值各不相同.海绵状血管瘤呈中高波峰,平均Q-I值25%,均匀衰减.泪腺多形性腺瘤衰减明显,前1/2段波峰陡峭下降,后1/2段为中低波峰,平均Q-I值16%.泪腺腺样囊性癌衰减明显,基线前1/3段波峰陡峭下降,后2/3段为低波峰,间杂中波峰或无波峰.平均Q-I值12%.神经鞘瘤为中低波峰,间杂无波峰的平段.平均Q-I值9%.血管外皮瘤为甚低波峰,间杂无波峰的平段.平均Q-I值5%.横纹肌肉瘤为无波峰的平段,无明显声衰减.间杂甚低波峰.平均Q-I值2%.黏液囊肿在入肿瘤波峰前有少许中高波峰,内回声为均一的平段,无声衰减,平均Q-I值0.结论标准化A型超声对于眼眶肿瘤的诊断具有一定参考价值,具有一定的鉴别诊断意义.     

伽玛刀治疗视神经鞘脑膜瘤长期疗效评价

0例,无变化8例,增大2例,肿瘤控制率为93.3%(28/30).治疗45个月后肿瘤控制率趋于稳定.治疗后视力提升11例(36.7%).减退6例(20.0%),无变化13例(43.3%).4例曾出现一过性球结膜水肿.患者眼眶肿瘤手术史、肿瘤容积和累及范围等因素与肿瘤控制率均无统计学意义上的关联(P>0.05).结论 伽玛刀治疗视神经鞘脑膜瘤可在较长时期内控制肿瘤生长,可保留部分视力,并发症较少.     

Efficacy of Iliac Crest vs. Medpor in Orbital Floor Reconstruction

Aim  

The present study is to compare the effectiveness of iliac crest graft and medpor implant, for repairing traumatic orbital floor defects.     

Quantitative analysis of diplopia following orbital fracture repair

Orbital fractures can result in devastating functional complications to sight and well-being, yet our understanding of functional sequelae post reconstruction is not well understood in the literature. This research retrospectively analysed the activity of a specialist orbital surgeon over five years to evaluate the incidence of, and risk factors for, debilitating complications such as diplopia and restriction of extraocular movement. Orbital fracture cases repaired between 1 January 2015 and 31 December 2019 were retrospectively analysed. Demographics, orthoptic assessment, injury classification, timing, operative details, outcomes, and complications were recorded. Preoperative and postoperative binocular single vision scores (BSV) were recorded to calculate the effect of orbital repair on residual diplopia. Of 582 patients undergoing orbital access, 472 cases of orbital wall reconstruction satisfied the inclusion criteria, of which 162 (34%) were Jaquiéry 4 or 5. Overall, 10.6% had complications, 4.9% had diplopia, and 5.7% were returned to theatre. All those with residual diplopia had had it preoperatively, and had evidence of an improvement in BSV score. Time to surgery, material, and pure orbital fractures had a significant impact on the incidence of diplopia. Defect size did not. Whilst complication rates were low we conclude that strict adherence to a defined surgical protocol, postoperative imaging, and objective assessment of postoperative function are central to maintaining these standards. Objective orthoptic analysis of patients before and after orbital repair is critical to our understanding of this pathology. Whilst preoperative prediction of the persistence of long-term diplopia currently eludes us, further research should target it.