超声活体显微镜和CT诊断眼前段异物的对比分析

目的 探讨超声活体显微镜(UBM)和CT两种不同成像方法 对眼前段异物诊断的优缺点及联合应用的价值.方法 为比较研究,收集2000年7月至2007年5月共44例疑诊为眼前段异物的患者同时行UBM和CT检查的资料,并与其手术结果 相对照.结果 CT扫描发现其中40例表现为高密度影,分别为铁、铜、石块、玻璃等;2例稍高密度影,均为塑料;2例无异常发现者分别为竹签和板栗刺.44例患者UBM检查均表现为强回声光斑伴声影.结论 CT对眼前段异物难以精确定位和发现并发症.UBM对所有眼前段异物均可准确定位,并能发现异物相关并发症.但其操作复杂,扫描视野小,检查费时.眼前段异物诊断的最佳方案为先行CT扫描确定异物方位及异物种类,再行UBM检查确定异物准确位置,发现并发症.(中华眼科杂志,2008,44:229-232)

Comparison of ultrasound biomicroscopy and CT in diagnosis of anterior segment intraocular foreign body

OBJECTIVE: To report the appearance of anterior segment intraocular foreign body in ultrasound biomicroscopy (UBM) and CT. To investigate the advantage and disadvantage of these two imaging methods and to evaluate the value of combining application of these methods in the diagnosis of anterior segment intraocular foreign body. METHODS: It was a comparative study. Forty-four cases of suspected anterior segment intraocular foreign body were simultaneously examined by UBM and CT from July 2000 to May 2007, the results were compared with the operation results. RESULTS: In 44 cases examined by CT, foreign bodies in 40 cases showed high density shadows, including iron, copper, stone and other foreign bodies; 2 cases showed slightly high density shadow, which were identified as plastics; in 2 cases, the foreign bodies could not be detected by CT, which were bamboo pick and Chinese chestnut sting. It was difficulty to locate the foreign body exactly and to detect the complications of anterior segment intraocular foreign body by using CT. All 44 cases of anterior segment intraocular foreign body showed strong echo spot with acoustic shadow in the UBM. UBM could provide the exact location of foreign body and could detect all complications. But the examining procedure of UBM was complicated, the examining screen was relatively narrow and the examination was time-consuming. CONCLUSION: In suspected anterior segment intraocular foreign body, CT examination should be performed first to detect the position and the nature of foreign body, then UBM could be used to obtain the exact position of foreign body and to detect the complications.