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中华医学超声杂志(电子版) ›› 2024, Vol. 21 ›› Issue (06) : 580 -584. doi: 10.3877/cma.j.issn.1672-6448.2024.06.005

浅表器官超声影像学

高频线阵探头对眼球壁的临床观察
王子杨1, 杨文利1,(), 李栋军1, 陈伟1, 赵琦1, 李逸丰1, 崔蕊1, 沈琳1, 刘倩1, 魏串串1   
  1. 1. 100730 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2024-03-01 出版日期:2024-06-01
  • 通信作者: 杨文利
  • 基金资助:
    国家重点研发计划项目(2018YFC0116000)

Clinical observation of the eyeball wall with high frequency linear array probe

Ziyang Wang1, Wenli Yang1,(), Dongjun Li1, Wei Chen1, Qi Zhao1, Yifeng Li1, Rui Cui1, Lin Shen1, Qian Liu1, Chuanchuan Wei1   

  1. 1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology& Visual Sciences Key Laboratory, Beijing 100730, China
  • Received:2024-03-01 Published:2024-06-01
  • Corresponding author: Wenli Yang
引用本文:

王子杨, 杨文利, 李栋军, 陈伟, 赵琦, 李逸丰, 崔蕊, 沈琳, 刘倩, 魏串串. 高频线阵探头对眼球壁的临床观察[J]. 中华医学超声杂志(电子版), 2024, 21(06): 580-584.

Ziyang Wang, Wenli Yang, Dongjun Li, Wei Chen, Qi Zhao, Yifeng Li, Rui Cui, Lin Shen, Qian Liu, Chuanchuan Wei. Clinical observation of the eyeball wall with high frequency linear array probe[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(06): 580-584.

目的

探讨高频线阵探头对眼球壁的观察,并对引起球壁回声增厚的疾病及其超声表现进行分析。

方法

这是一项回顾性横断面研究。回顾分析2023年9月至2023年10月于首都医科大学附属北京同仁医院眼科中心行眼部彩色多普勒超声检查的患者的超声图像。所有患者均采用线阵探头采集图像,探头频率为4~20 MHz。观察正常眼球壁的声学表现。对于表现为球壁回声增厚的患者,结合临床诊断统计病因,并对其超声表现进行分析。

结果

共纳入10 340例患者,正常眼球壁在超声表现为强回声,层间结构(视网膜、脉络膜、巩膜)不易分辨。球壁回声增厚患者139例(160只眼),其中低眼压相关疾病所致(包括眼外伤、视网膜脱离、手术后低眼压、陈旧眼部病变)106例(109只眼)、小眼球10例(20只眼)、葡萄膜炎6例(10只眼)、后巩膜炎6例(7只眼)、眼内炎5例(5只眼)、弥漫性脉络膜血管瘤4例(7只眼)、脉络膜转移癌1例(1只眼)、葡萄膜淋巴瘤1例(1只眼)。球壁回声增厚时球壁的层间结构可部分被分辨。

结论

高频线阵探头对眼球壁的观察具有重要价值。球壁回声的增厚多见于累及脉络膜、巩膜及巩膜外Tenon's囊的疾病。结合不同超声表现可对引起球壁回声增厚的疾病进行鉴别。

Objective

To observe the eyeball wall using a high-frequency linear array probe, and to analyze different ultrasound manifestations of eyeball wall thickening.

Methods

This was a retrospective cross-sectional study in which eye color Doppler ultrasonography images obtained from September to October 2023 in Beijing Tongren Hospital were retrospectively analyzed. All images were obtained using a linear array probe, and the probe frequency was 4 to 20 MHz. The ultrasound manifestations of the eyeball wall were investigated. The ultrasound features of eyeball wall thickening were analyzed in combination with clinical diagnosis.

Results

The imaging data of 10340 patients were included in this study. The normal eyeball wall showed strong echo on ultrasound, and the interlayer structures (the retina, choroid, and sclera) were difficult to distinguish. There were 139 patients (160 eyes) with thickened eyeball wall echo. Diseases that cause thickening of eyeball wall echo included diseases related to low intraocular pressure (such as ocular trauma, retinal detachment, postoperative low intraocular pressure, and old eye diseases) in 106 patients (109 eyes), microphthalmia in 10 (20 eyes), uveitis in 6 (10 eyes), posterior scleritis in 6 (7 eyes), endophthalmitis in 5 (5 eyes), diffuse choroidal hemangioma in 4 (7 eyes), choroidal metastasis in 1 (1 eye), and uveal lymphoma in 1 (1 eye). When there was echo showing that the eyeball wall thickened, the interlayer wall structure could be partially distinguished.

Conclusion

High-frequency linear array probe can be used to observe the eyeball wall. Thickening of the eyeball wall is more common in diseases involving the choroid, sclera, and Tenon's capsule. These diseases can be differentially diagnosed by combining different ultrasound manifestations.

图1 正常眼球壁示意图及超声表现注:1为视网膜;2为脉络膜;3为巩膜;4为Tenon's间隙;5为Tenon's囊
图2 不同疾病引起球壁回声增厚的超声图像。图a为男性患者,60岁,双眼真性小眼球,超声表现为双眼巩膜回声增厚,呈均匀高回声;图b为女性患者,59岁,左眼后巩膜炎,超声表现为左眼球壁回声增厚,球后可见低回声区,与视神经相连形成"T"形征;图c为女性患者,37岁,双眼Vogt-小柳原田综合征(VKH),超声表现双眼脉络膜增厚,内回声均匀为低回声,同时伴有玻璃体混浊和视网膜脱离;图d为男性患者,14岁,左侧颜面血管瘤,左眼弥漫性脉络膜血管瘤(Sturge-Weber综合征),超声表现为左眼脉络膜增厚呈均匀中等回声,彩色多普勒血流成像(CDFI)检查其内有丰富血流信号注:1为视网膜;2为脉络膜;3为巩膜;4为Tenon's间隙
表1 引起球壁回声增厚的疾病及超声表现
图3 视网膜水肿超声及光学相干断层扫描(OCT)图像。图a为后极部球壁前可见膜状回声,形成浅间隙;图b为OCT检查显示视网膜水肿
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