以眼部症状首诊的良性颅内压增高的MRI影像学特征
发布时间：2018-08-11 08:38
【摘要】：目的探讨以眼部症状首诊的良性颅内压增高(BIH)患者的眼部MRI影像特点。设计回顾性病例系列。研究对象65例经临床确诊的良性颅内压增高病例。方法回顾性分析患者临床资料及颅脑、眼眶MRI数据,统计各主要影像征象在本组患者中出现的比例,比较各影像征象在特发性颅内压增高(IIH)、颅内静脉窦血栓形成(CVST)及细胞数增多的BIH之间的差异及MRI诊断与眼底镜检查结果的差异。主要指标颅脑、眼眶MRI影像表现。结果 65例良性颅内压增高患者中,多数存在空蝶鞍(78.5%)、视神经周围蛛网膜下腔增宽(74.1%),其次是视乳头隆起(55.9%),视神经走行迂曲(37.3%)、眼球后壁后巩膜变扁平(34.0%)和视神经本身(粗细、信号、强化程度)异常(33.9%),小脑扁桃体下疝(7.7%)。视神经周围蛛网膜下腔增宽在IIH组发生率与CVST和细胞数增多的BIH均存在差别(χ~2=10.161,P=0.001;χ~2=6.065,P=0.014)。与眼底镜结果比较MRI检测视乳头水肿的敏感度52.8%,特异度58.3%。结论除空蝶鞍外,视神经周围蛛网膜下腔增宽是以眼部症状首诊的BIH患者常见MRI表现,可单独或合并多种MRI征象出现。
[Abstract]:Objective to investigate the features of ocular MRI in patients with benign intracranial hypertension (BIH) who were first diagnosed with ocular symptoms. Design retrospective case series. Participants 65 cases of benign intracranial hypertension confirmed by clinical diagnosis. Methods the clinical data, craniocerebral and orbital MRI data were analyzed retrospectively. To compare the difference of various imaging signs between (CVST) and BIH of intracranial venous sinus thrombosis (CVST) in (IIH), with increased intracranial pressure, and the difference between MRI diagnosis and fundus endoscopy. Main outcome measures Imaging of craniocerebral and orbital MRI. Results in 65 patients with benign intracranial hypertension, most of them had empty Sella (78.5%), subarachnoid space around optic nerve (74.1%), optic papilla protuberance (55.9%), optic nerve traverse and detour (37.3%), posterior sclera flattening (34.0%) and optic nerve itself (thick and thin). Signal intensity was abnormal (33.9%) and cerebellar subtonsillar hernia (7.7%). The incidence of subarachnoid space widening around the optic nerve in IIH group was significantly higher than that in CVST group and BIH with increased cell count (蠂 ~ 2 ~ 2 ~ (2) 10.161 ~ (-1) P ~ 0. 001; 蠂 ~ (2) n = 6.065 ~ 0. 014). The sensitivity and specificity of MRI in the detection of papillary edema were 52.8% and 58.3% respectively. Conclusion the enlargement of subarachnoid space around the optic nerve is a common MRI manifestation in BIH patients with ocular symptoms except empty Sella, and may appear alone or in combination with multiple MRI signs.
【作者单位】： 首都医科大学附属北京同仁医院放射科;
【分类号】：R741;R445.2
本文编号：2176468
[Abstract]:Objective to investigate the features of ocular MRI in patients with benign intracranial hypertension (BIH) who were first diagnosed with ocular symptoms. Design retrospective case series. Participants 65 cases of benign intracranial hypertension confirmed by clinical diagnosis. Methods the clinical data, craniocerebral and orbital MRI data were analyzed retrospectively. To compare the difference of various imaging signs between (CVST) and BIH of intracranial venous sinus thrombosis (CVST) in (IIH), with increased intracranial pressure, and the difference between MRI diagnosis and fundus endoscopy. Main outcome measures Imaging of craniocerebral and orbital MRI. Results in 65 patients with benign intracranial hypertension, most of them had empty Sella (78.5%), subarachnoid space around optic nerve (74.1%), optic papilla protuberance (55.9%), optic nerve traverse and detour (37.3%), posterior sclera flattening (34.0%) and optic nerve itself (thick and thin). Signal intensity was abnormal (33.9%) and cerebellar subtonsillar hernia (7.7%). The incidence of subarachnoid space widening around the optic nerve in IIH group was significantly higher than that in CVST group and BIH with increased cell count (蠂 ~ 2 ~ 2 ~ (2) 10.161 ~ (-1) P ~ 0. 001; 蠂 ~ (2) n = 6.065 ~ 0. 014). The sensitivity and specificity of MRI in the detection of papillary edema were 52.8% and 58.3% respectively. Conclusion the enlargement of subarachnoid space around the optic nerve is a common MRI manifestation in BIH patients with ocular symptoms except empty Sella, and may appear alone or in combination with multiple MRI signs.
【作者单位】： 首都医科大学附属北京同仁医院放射科;
【分类号】：R741;R445.2
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1 李宪章;良性颅内压增高的 CT 表现[J];国外医学(临床放射学分册);1986年05期
2 ;[J];;年期
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