摘要
目的 探讨Brown综合征的临床特征与影像学诊断.方法 回顾性系列病例研究.回顾性分析2011年4月至2014年10月临床诊断为单侧Brown综合征的患者14例,其中先天性10例,后天性4例;男性12例,女性2例,年龄3～54岁,年龄中位数为4岁.对所有患者均进行了斜视度数、眼球运动、双眼视觉、前节及眼底检查.眼球运动神经脑池段采用头线圈,3D-FIESTA序列;眼眶段采用表面线圈,横断面加冠状面加矢状面,快速自旋回波T1与T2加权扫描.分析眼球运动神经、眼外肌及周围组织MRI表现.结果 所有患者均有内上转运动受限.10例为先天性Brown综合征,9例MRI显示患侧不同程度的上斜肌发育不良,1例患侧滑车区团状低信号影.后天性Brown综合征4例,上斜肌前部限局粘连1例,滑车附近组织粘连1例,眶壁骨折2例.结论 Brown综合征是一组临床表现相近、发病机制复杂的限制性斜视.MRI能清晰显示上斜肌全程及周围组织的异常改变.
Objective Brown syndrome is characterized by limitation of elevation in adduction,with complex mechanisms involving muscle,tendon,and trochlea.Here,we investigated mechanisms of Brown syndrome by magnetic resonance （MR） imaging.Methods It was a retrospective case series study.Fourteen patients with unilateral Brown syndrome between 3 and 54 years of age （l0 cases of congenital and 4 cases with acquired disease） were included in the study.All patients underwent complete ophthalmic and orthoptic evaluation.Imaging of the ocular motor nerves at the brainstem was performed on 3D-FIESTA sequence,the orbits were imaged with FSE T1 、T2WI using surface coils.Results Nine of 10 with congenital Brown syndrome demonstrated hypoplasia of the superior oblique （SO） of the affected side.Abnormal low signal intensity in the trochlea area was found in one patient.Three of 4 acquired patients had a history of trauma and were demonstrated fracture of the trochlea,extensive scarring,and superior orbital fracture.One acquired case was demonstrated scarring of anterior part of the SO and hypoplasia ofthe posterior part.Conclusion Brown syndrome consists of a series of diseases.Their clinical features are quite similar while their anatomical mechanism varies in numerous ways.Therefore,based on patient＆#39;s individual pathophysiology,the management in Brown syndrome should be personalized.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2015年第6期429-433,共5页
Chinese Journal of Ophthalmology
基金
首都卫生发展科研专项项目（2011-2005-05）
关键词
眼球运动障碍
斜视
磁共振成像
Ocular motility disorders
Strabismus
Magnetic resonance imaging
