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B-co-CT in the diagnosis of intraocular foreign body location of_4299

By Gregory Garcia,2014-10-30 09:36
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B-co-CT in the diagnosis of intraocular foreign body location of_4299

    B-co-CT in the diagnosis of intraocular foreign body location of

     Abstract Objective To investigate the balls foreign body, ultrasound and clinical value of CT imaging position. Methods B separately in patients with ultrasound and CT examination, diagnosis of foreign body,

    locate and compare the results with the surgery. B-imaging results of 55

    eyes of 55 patients, CT imaging in 53 cases, according to CT-and intra-

    operative foreign body was found generally consistent. Conclusions B-right

    combination of CT diagnosis and localization of intraocular foreign bodies is a good way.

     Key words B-Ball foreign body CT -

     Abstract Objective To explore the diagnostic value of combining CT and B-type ultrasound in localization of intraocular foreign bodies.

    Methods 55 cases with 55 intraocular foreign bodies were detected and localized by CT and B-type ultrasound scan. 55 cases with 55 intraocular foreign bodies were detected and localized by B-type ultrasound combined

    with CT. The observation were compared to the introoperative findings. Results All 55 foreign bodies wre detected by CT and B-type ultrasound

    scan. The accuracy of B-type ultrasound combined with CT in localization was high. Conclusion CT scan combined with B-type ultrasound is feasible

    and should be routinely carried out in diagnosis and localization of intraocular foreign bodies.

     Key words Intraocular foreign bodies B-type ultrasound CT

    Localization According to statistics, foreign body eye trauma in the ball about 6% [1]. Traditional X-imaging technology only for metallic foreign body within the eye, and a certain lack of orientation. At present the

    advantages of B ultrasonography and CT has been recognized by clinicians, and widely used in the diagnosis of intraocular foreign bodies, and positioning. The authors concluded from February 2004 to March 2008 were treated 55 cases of eye balls ward foreign body patients, the use of CT diagnosis of B-binding situation.

     A clinical data

     1.1 General Information of this group of 55 patients (55 eyes) patients, male 45 cases, female 10 cases; aged 18 to 56 years of age. 20

    cases of left eye, right eye 35 cases. Visual acuity from the front manual ~ 0.1. Patients had a clear history of trauma, there are characteristics of the ball within the foreign body in patients with suspected foreign body ball.

     1.2 B-ultrasonic examination using Alokassd-900 ultrasonic diagnostic

    apparatus, controlling the first frequency of 3.5MHz, patients with supine position, light eyes closed, coated coupling agent, Zhu Huanzhe the eye up, down, left, right rotation, the eye various diameter wire probe

    contact with suspected anterior segment foreign body increases with the water bladders.

     1.3 CT examination with the U.S. Marconi 8000 Multi-row CT machine,

    patients with supine position, head and later Yang, look directly above the eyes, scanning the baseline for the hearing infraorbital line (outer ears to the lower edge of the orbit connection) from the inferior orbital rim plain to the superior orbital margin, from the thick layer of 2mm, window width 300 ~ 400Hu, window level 30 ~ 50Hu, and in accordance with

    the CT value of foreign body to adjust. Axial images will be scanned by the coronal reconstruction of or additions to coronal scan, you can get foreign bodies in coronal orientation. In the axial CT images both sides of the eye ring, lens, optic nerve, muscle cone and so clearly show, and foreign bodies in the electronic tape measure the vertical distance from the limbus. In the chip to draw the coordinates from the coordinate origin to the foreign body to do connection to Measure the foreign body to the X

    and Y axis of the vertical distance.

     1.4 surgical methods for the B-ultrasound has a strong echo, CT

    examination identified as magnetic metallic foreign bodies were away from the eye wall in order to electromagnets aspiration as the preferred method

    of operation for the B prompt for the low-intensity ultrasound echo of the

    non-metallic foreign bodies, and CT Developing non-magnetic metallic

    foreign body to determine who, according to location of line vitrectomy foreign body foreign body removed or crystals removed.

     2 Results

     2.1 The foreign body nature of the 55 intraocular foreign bodies by ultrasound examination showed patchy strong echo in the back with "tail sign" or the sounds of 55 cases, CT imaging diagnosis of foreign bodies in

    53 cases (two cases of missed diagnosis of thorn for the wood). Later confirmed by surgery for 55 eyes of 38 patients with magnetic metal foreign body, five cases of non-magnetic metallic foreign body (5 cases

copper); 12 cases of non-metallic foreign body in seven cases of stone

    tablets, 3 cases of glass, two cases of thorn trees. Reposted elsewhere in the paper for free download http://

     2.2 The foreign body positioning the ball a total of 39 cases of foreign bodies within the vitreous, B ultrasound diagnosis of 39 cases, CT diagnosis of 39 cases; the ball a total of three cases of foreign body wall, B ultrasound diagnosis of two cases (one cases of missed diagnosis of B-crystals that are foreign body), CT diagnosis of 4 cases (1 case of

    misdiagnosis of foreign body in front of the retina); crystals were 13 cases of foreign bodies, B ultrasonic diagnosis in 8 cases, CT diagnosis of 13 cases. According to the positioning of CT combined with B-, crystal

    foreign bodies were successfully removed, the glass body are three cases of magnetic foreign body aspiration with electromagnets failed, including two cases of aspiration to change the location of scleral incision, and 1 relay with magnetic bar sucked out (which is ferroalloy). Ball wall

    foreign bodies, non-magnetic foreign bodies with vitrectomy can be

    successfully removed, patients found the preoperative diagnosis of foreign body position and the basic line.

     2.3 complications in 55 eyes of the combined total of 18 cases of

    vitreous hemorrhage, B ultrasonography in 18 cases, accuracy was 100%, CT was found in 11 cases, accuracy was 61%. Combined five cases of endophthalmitis, B found in four cases of super, CT was found in 1 case. Combined total of nine cases of retinal detachment, B super-found 7 cases,

    CT was found in 4 cases. 27 cases of eyeball rupture the merger, B was found nine cases of super, CT found in 20 cases. 4 cases of orbital fracture, B super-found 0 cases, CT was found in 4 cases. In 2 cases of extraocular muscle injury, B ultrasonography 0 cases, CT was found in 2 cases.

     3 Discussion

     Intraocular foreign bodies is a common eye disease, trauma, foreign body detection and positioning is the key to diagnosis and treatment. In the early days because of the backwardness and shortage of

    medical equipment, X-ray localization method most widely used, X-line for

    high-density foreign bodies to determine fairly accurate, but the low density foreign body is difficult to imaging. And the X ray can not show

    the eye structure, the positioning of foreign bodies is based on the standard eye to project. In clinical applications, X ray in patients with ocular surface requires sewing ring to locate the position, increasing the patient's pain, children do not fit in eyeball rupture ? period can not

    be sutured. Therefore, relative to the X ray, CT has obvious advantages, it has the ball in the diagnosis of foreign bodies have been widely accepted by clinicians (1), according to CT value and the availability of radial artifacts speculative nature of foreign body, and accurate positioning, a clear indication of foreign body with the eye the distance between the organizations, its high resolution, positioning accurate,

error is less than 1mm. (2) can be displayed simultaneously with other eye

    damage, such as bleeding, orbital fracture, eye muscles and optic nerve damage. (3) simple operation painless. Although magnetic resonance reported in the literature on the ball inside the tiny non-magnetic

    foreign body and the ball inside the detection rate of complications is higher than CT, and its non-radiation applied to pregnant women [2].

    However, metallic foreign body is the taboo, there is the use of ferromagnetic foreign body MRI may damage nerves, while in China According to statistics, foreign body magnetic intraocular foreign bodies accounted for 82% to 90% [1], with a pacemaker who is also a taboo subject, and the price higher than the CT, it is not conducive to the promotion of clinical. At present ultrasound imaging in the diagnosis of foreign bodies

    in the ball played a significant role. Whether it is metallic or non-

    metallic foreign body foreign body, ultrasound Jieke show its existence. Ultrasound has a measurement system, according to the clock method to locate foreign bodies. And simple operation, no side effects. For the ball the ball inside or outside the foreign body identification, B super show more clearly. At the same time, for the ball-wall foreign bodies, B

    ultrasonic examination in the dynamic observation, so the ball-wall

    foreign bodies can be wall movement with the ball rotation, better diagnosis. However, ultrasound can not determine the nature of the foreign body. LIU Wei et al [3] on 60 intraocular foreign body X-ray and B-

    observation, found that X-metallic foreign body for diagnostic and

    positioning very accurate and superior to ultrasound, while the B-edge can

    be found in its very small are not easily discovered by X-ray metal

    foreign body and the majority of non-metallic foreign body. In this group

    of 35 eyes with the B-the first to discover the eye foreign body, when

    combined with CT to determine the nature and exact location of foreign bodies, aware of the other complications, can guide understanding of his illness in time to take the proper surgical method to reduce surgical trauma and side-effects. In the diagnosis of complications, B-mode

    ultrasonography to vitreous hemorrhage and endophthalmitis sensitive than CT. In this group 2 cases of extraocular muscle injury in B-were not found

    may be related to clinicians do B-inspection, eye muscle strength is not

    enough concern about a relationship. The eyeball broken orbital bone fracture area, CT has obvious advantages.

     References

     1 Pangxiu Qin, Wen-Wei Wang, editor. Tongren eye trauma therapeutics. Beijing: Science and Technology Press, 2006.10.

     2 Xiu-Yu Wang, CHENG Jing-liang, SHI Guang-Pu, et al. Intraocular foreign

    body in the clinical application of MRI. Zhonghua Radiology, 1996,30 (10):

    678 ~ 681.

     3 Wei Liu, Hong-Bin. Ultrasonography and X-ray image to determine the

    ball position within the clinical analysis of 60 foreign bodies. Henan Science and Technology University (Medicine Edition), 2006 24 (1): 50 ~

    52. Reposted elsewhere in the paper for free download http : / /

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