目的：应用磁共振CUBE 3D T2WI脂肪抑制序列对外伤后视神经损伤进行研究。方法：选取20例临床以眼眶外伤病史来诊、同时伴有视力损伤的患者行眼眶磁共振冠状位STIR序列及CUBE 3D T2WI脂肪抑制序列扫描视神经全程及视交叉，并对视神经图像分析及读片，根据视神经各段信号有无异常及信号异常的程度（异常、可疑异常、无异常）进行分析和评价，并将影像结果与临床眼科检查结果进行对比分析。结果：STIR序列显示视神经损伤情况分别为异常50.0%（10/20），可疑异常20.0%（4/20），无异常30.0%（6/20）；3D CUBE序列显示视神经病变异常情况为信号异常55.0%（11/20），可疑异常30.0%（6/20），无异常15.0%（3/20）。结论：磁共振CUBE 3D T2WI脂肪抑制序列可以在较短的扫描时间内获得眼眶三维容积图像，对于视神经各段损伤的情况进行全面、准确的判断，尤其是对于视神经管内段及颅内段的损伤情况判定具有明显优势，对视神经损伤的检出率明显高于眼眶常规STIR扫描序列。
Abstract
Objective: To evaluate the diagnostic value of CUBE 3D T2WI fat suppression sequence in traumatic optic nerve injury. Methods: Twenty patients with orbital trauma were enrolled in this study. MR examination of STIR sequence and CUBE 3D T2WI fat suppression sequence was performed, which can get the imaging of optic nerve and optic chiasma. And then imaging were analyzed. According to the optic nerve segment of the signal with or without abnormalities and abnormalities degree of the signal(abnormal, suspicious anomalies, normal) for analysis and evaluation. Imaging results and clinical ophthalmic examination results were compared. Results: On the STIR sequences abnormal optic nerve injury was 50.0%(10/20), suspicious anomalies 20.0%(4/20), normal 30.0%(6/20); on 3D CUBE sequence, abnormal optic nerve disease was 55.0%(11/20), suspicious anomalies 30.0%(6/20), normal 15.0%(3/20). Conclusion: The CUBE 3D T2WI fat suppression sequence was significantly higher than the orbital conventional STIR scan sequence.
关键词
视神经损伤 /
磁共振成像
Key words
Optic nerve injuries /
Magnetic resonance imaging
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]王鹏，冯三江，郑远征，等. 颅脑外伤合并视神经损伤29例临床分析[J]. 疑难病杂志，2015，14（9）：967-968.
[2]张志强，陈湘光，范伟雄. 螺旋CT及MRI在外伤性视神经病诊断中的价值[J]. 中国CT和MRI杂志，2015，13（4）：24-26.
[3]关计添，耿义群，程英，等. 1.5T磁共振STIR序列在外伤性视神经损伤的应用[J]. 中国CT和MRI杂志，2012，10（3）：8-10.
[4]肖慧，马林. 磁共振成像在视神经脊髓炎中的应用进展[J]. 中国医学影像学杂志，2010，12（1）：63-67.
[5]Wingerchuk DM, Lennon VA, Pittock SJ, et al. Revised diagnostic criteria for neuromyelitis optica[J]. Neurology, 2006, 66(10): 1485-1488.
[6]Busse RF, Hariharan H, Vu A, et al. Fast spin echo sequences with very long echo trains: design of variable refocusing flip angle schedules and generation of clinical T2 contrast[J]. Magn Reson Med, 2006, 55(5): 1030-1037.
[7]董玉茹，王宏，马毅，等. 水成像在视神经磁共振扫描中应用[J]. 中国CT和MRI杂志，2015，13（2）：15-18.
[8]Kremer S, Renard F, Achard S, et al. Use of Advanced Magnetic Resonance Imaging Techniques in Neuromyelitis Optica Spectrum Disorder[J]. JAMA Neurol, 2015, 72(7): 815-822.
[9]杨靖，朱越，周军，等. 磁共振3D CUBE T2WI脂肪抑制序列对视神经病变诊断价值的研究[J]. 中国实用神经疾病杂志，2014，17（11）：116-118.
[10]Aiken AH, Mukherjee P, Green AJ, et al. MR Imaging of Optic Neuropathy with Extended Echo-Train Acquisition Fluid-Attenuated Inversion Recovery[J]. Am J Neuroradiol, 2011, 32(2): 301-305.
[11]Sherman E, Han MH. Acute and Chronic Management of Neuromyelitis Optica Spectrum Disorder[J]. Curr Treat Options Neurol, 2015, 17(48): 1-14.
