【摘要】 目的探讨螺旋CT及MRI在泪道阻塞性疾病诊断中的临床应用价值。方法对26例泪溢患者进行螺旋CT扫描及MRI检查。CT扫描数据经工作站做多平面重建,MR检查前向双侧结膜囊滴入无菌盐水,MRI扫描序列为三维快速反转自旋回波泪道成像(3d-FRFSEMRD),泪溢者同时加做了冠状面及横断面快速自旋回波T2WI序列。上述检查后3～5d对患者进行泪道内镜检查。结果 26例(48侧泪溢症状)中单纯泪小管或泪囊阻塞者19侧,CT无法检出,由MRI检出14侧;鼻泪管阻塞者29例,螺旋CT检出26例,MRI检出24例;统计学分析,螺旋CT在前两种阻塞情况与MRI相比较,差异有统计学意义(P<0.05),而在鼻泪管阻塞,二者相比差异无统计学意义(P>0.05)。CT与MRI判断的阻塞部位与内镜的符合率为66.7%(32/48)。结论 CT多平面重建为鼻泪管阻塞的诊断和治疗提供重要信息。鼻泪管滴注无菌盐水后MRI可以清晰显示泪囊及鼻泪管,螺旋CT在泪小管及泪囊水平的阻塞检出率较差,而在鼻泪管阻塞的检出率中与MRI相近,二者互补检出率则明显提高。更多还原

【Abstract】 Objective To probe the clinical utilization of spiral CT and MRI in the diagnosis of the lacrimal duct obstruction.Methods 26 patients affected by primary epiphora underwent Spiral CT and MRI.The 3 d model of lacrimal passage was reconstructed with CT scanning.The sequence of MRI were 3 d-FRFSE MRD and axial as well as coronal FRFSE T2WI.Before MRI examination,sterile saline solution had been instilled into the conjunctival sac.All these patients underwent lacrimal endoscopy 3~5 days after MR examination,which served as a standard reference for MR and CT findings.Results 26 cases(48 sides) of lacrimal duct obstruction,revealed 14 sides of Lacrimal sac obstruction at MRI,CT can not reveal,29 sides at nasolacrimal duct,26 sides by CT and 24 sides by MRI.There were significant difference in detection of canaliculus and lacrimal cysts obstructions(P< 0.05),but no difference in nasolacrimal duct obstructions(P> 0.05).The accuracy of MRI and CT in diagnosing obstructive level was 66.7%(32/48).Conclusion Multiplanar reconstruction of Spiral CT supplies an important information for diagnosis and treatment.MR imaging performed after the topical administration of steril solution can reveal the lacrimal sac well and whole course of the nasolacrimal duct.CT is worse than MRI in detection of canaliculus and lacrimal cysts obstructions and approximate in detection of nasolacrimal duct obstructions.Improved obviously detection of lacrimal duct obstruction with CT and MRI together更多还原