摘要
目的:分析眶内非金属异物的影像学表现,提高对该病的诊断准确性。方法:回顾性分析2013年-2020年经手术证实的33例眶内非金属异物患者的CT和MRI资料。所有患者均行CT检查,其中19例行MRI检查。根据异物存留时间分为急性期(<5天)、亚急性期(5~30天)和慢性期(>30天)。结果:33例眼眶异物中,植物性异物30例,机油异物3例,继发感染28例。30例植物性异物中,急性期15例,异物CT值为-700~-300 HU,其中3例异物在T_(1)WI、T_(2)WI均呈低信号;亚急性期5例,异物密度从内到外逐渐升高,其中3例异物在T_(1)WI、T_(2)WI呈混杂等低信号,异物周围炎性组织明显强化;慢性期10例,异物呈等-高密度,CT值为40~70 HU,10例异物T_(1)WI呈等-高信号,T_(2)WI呈偏低信号,无强化,包裹异物的肉芽肿明显强化。3例机油性异物CT值为-130~-110 HU,T_(1)WI和T_(2)WI均呈高信号,压脂呈低信号,无强化,异物肉芽肿明显强化。结论:CT是眼眶非金属异物急诊首选检查方法,灵活调整窗宽窗位可提高急性期异物检出率,不同存留时间段的植物性异物密度不同。MRI对急性期明确有无异物和评估继发感染更有优势。
Objective:To improve the diagnostic accuracy by analyzing the imaging appearance of orbital nonmetal foreign bodies.Methods:Thirty-three cases with orbital nonmetal foreign bodies proved by surgery were enrolled and analyzed respectively.All cases underwent CT scanning and 19 of these cases performed MRI scanning.They were divided into 3 groups according to the course of disease:acute stage(<5 days),subacute stage(5~30 days)and chronic stage(>30 days).Results:Among all cases,there were plant foreign bodies in 30 cases and machine oil foreign bodies in 3 cases.Twenty-eight cases were complicated by intraorbital and adjacent structural inflammation.In 15 cases with acute plant orbital foreign bodies,the range of CT value was from-700HU to-300HU.Three of these 15 cases performed MRI and all showed hypointensity on T_(1)WI and T_(2)WI.In 5 cases with subacute plant orbital foreign bodies,the density of foreign bodies gradually increased from inside to outside.Three of these 5 cases underwent MRI showed heterogeneous iso-or hypointensity on T_(1)WI and T_(2)WI and obvious enhancement after injection of contrast material.In 10 cases with chronic plant orbital foreign bodies,they showed iso-or high-density and the CT value was from 40HU to 70HU.They manifested iso-or hyperintensity on T_(1)WI and slightly hypointensity on T_(2)WI.Although these foreign bodies were nonenhanced,the foreign-body granulomatous showed obvious enhancement.In 3 cases with machine oil foreign bodies,the CT value was from-130HU to-110HU.They all showed hyperintensity on T_(1)WI and T_(2)WI,and showed hypointensity on fat-suppression.These foreign bodies were nonenhanced,however foreign-body granulomatous showed obvious enhancement.Conclusion:CT is the primary choice for orbital nonmetal foreign bodies in emergency department and the diagnostic accuracy can be obviously improved by adjusting suitable window width and level.The density of plant foreign bodies change in different course of disease.MRI is the better choice to identify nonmetal forei
作者
陶建华
邹萌
陈青华
曲晓霞
李建红
康天良
刘兆会
TAO Jian-hua;ZOU Meng;CHEN Qing-hua(Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)
出处
《放射学实践》
CSCD
北大核心
2022年第7期829-833,共5页
Radiologic Practice
关键词
眼眶
非金属异物
植物性异物
机油
体层摄影术
X线计算机
磁共振成像
Orbital
Nonmetal foreign body
Plant foreign body
Machine oil
Tomography,X-ray computed
Magnetic resonance imaging
