摘要
目的探讨螺旋CT及磁共振成像(MRI)对外伤性视神经病(TON)的诊断及疗效判断价值。方法入选我院2011年6月-2013年6月收治的TON患者50例,采用三维重建CT技术及磁共振短时间反转恢复序列(STIR)扫描进行术前诊断,对比两种方法的诊断价值,术后采用STIR序列扫描评估视神经减压情况。结果螺旋CT检出率90.0%(45/50)与MRI检出率88.0%(44/50)差异不具有统计学意义(P>0.05);其中,CT检查视神经管骨折部位管前型10例,半管型13例,全管型19例,蝶鞍型3例,MRI检查视神经损伤类型水肿23例,鞘膜下出血6例,移位1例,萎缩19例,二者与病理学检查结果比较差异均不具有统计学意义(均P>0.05);患者行减压术后经磁共振STIR序列扫描,70.0%(35/50)的患者视神经损伤明显改善,16.0%(8/50)改善不明显,仍存在一定程度的水肿或萎缩,另有14.0%(7/50)无改善,眼球内陷,存在水肿、出血或萎缩。结论三维重建CT技术可清晰显示视神经管骨折,并准确定位,STIR序列扫描对软组织分辨率较高,可准确判断视神经损伤情况,并具有评估视神经减压情况的作用,二者结合诊断,可为临床制订合理诊疗方案提供更加充分和实用的影像学支持。
Objective To discuss Spiral CT and magnetic resonance imaging （MRI） on traumatic optic neuropathy （TON） whose diagnosis and curative effect judgment value. Methods 50 cases of patients with TON were admitted in our hospital from 2011 to June 2013,who were used the 3D reconstruction of CT and magnetic resonance short time inversion recovery sequence （STIR） scanning for preoperative diagnosis, the diagnostic value between two methods was compared ,after operation ,they were used STIR sequence scan evaluation of optic nerve decompression.Results The detection rate of Spiral CT was 90.0%（45/50）and the detection rate of MRI was 88.0%（44/50）, the difference had no statistical significance （P〉0.05）;Among them, there were10 cases of CT examination of the optic canal fracture site in front of the tube type, 13 cases of the half pipe type, 19 cases of full pipe, 3 cases of sphenoid saddle, 23 cases of MRI examination in nerve injury types of edema, 6 cases of Vaginal bleeding, 1 cases of displacement, 19 cases of atrophy, the comparison of both and test results of pathology were not statistically significant（all were P〉0.05）; Patients were treated with decompression after Mr STIR sequence scanning, 70% （35/50） of patients with optic nerve injury improved significantly, 16.0%（8/50）of patients did not improve significantly, there is also a certain degree of edema or atrophy.Conclusion CT 3D reconstruction can clearly display the optic canal fracture, and accurately positioned, STIR sequence scanning on soft group has higher resolution, can accurately judge the optic nerve injury, and it has the assessment of optic nerve decompression effect of the circumstances, the combination of the two diagnosis can provide more sufficient and practical imaging support for clinical reasonable treatment program.
出处
《中国CT和MRI杂志》
2015年第4期24-26,共3页
Chinese Journal of CT and MRI
