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1、磁共振成像技術(shù)3DFIESTA序列對溢淚病因分析的臨床應用價值[摘要]目的探討應用MRI淚道成像技術(shù)3DFIESTA序列對明確溢淚病因的臨床應用價值。方法溢淚患者50例(溢淚64側(cè)、正常36側(cè))行淚道MRI檢查。檢查前分四次向雙眼結(jié)膜囊滴入0.9%的NaCl注射液,掃描序列為三維快速平衡穩(wěn)態(tài)序列(3DFIESTA)、三維快速恢復快速自旋回波序列(3D-FRFSE)和快速恢復快速自旋回波(FRFSET2WI),并將3DFIESTA、3D-FRFSE序列的原始圖像做后處理及三維重建,觀察溢淚患者淚道顯示情況,并分析淚道阻塞的部位與原因。所有溢淚患者MRI檢查后1周內(nèi)進行內(nèi)窺鏡檢查和治療
2、,將3DFIESTA、3D-FRFSE和FRFSET2WI序列所得出的診斷與內(nèi)窺鏡檢查結(jié)果進行對照分析。結(jié)果64側(cè)溢淚淚道與內(nèi)窺鏡結(jié)果進行對照,3DFIESTA序列能顯示梗阻位置與病因61側(cè)(95.3%),F(xiàn)RFSET2WI顯示53側(cè)(82.8%),3D-FRFSE序列不能分析梗阻原因、顯示梗阻部位42側(cè)(65.6%),3DFIESTA序列診斷正確率顯著高于FRFSET2WI和3D-FRFSE序列,差異有統(tǒng)計學意義(x2=14.135,P<0.05)。有2側(cè)淚道功能不全和1側(cè)淚點狹窄以上三種檢查均未做出明確診斷。結(jié)論3DFIESTA序列對于溢淚病因分析明顯優(yōu)于3D-FRFSE序列和
3、FRFSET2WI序列,對于幫助臨床選擇治療方案有著重要的作用。[關(guān)鍵詞]溢淚;磁共振成像;3DFIESTAClinicalapplicationvalueofMRdacryocystographytechnique3DFIESTAtoanalysisthecauseofepiphora[Abstract]ObjectiveToexplorethevalueofMRdacryocystographytechnique3DFIESTAtoanalysisthecauseofepiphora.Methods50epiphorapatients(64epiphorasidesand36h
4、ealthysides)underwentMRIlacrimalexamination。Insillationof0.9%NaClsalinefourtimestobilateralconjunctivalsacbeforetheexam,thescanningsequencesincludedthree-dimensionalfastimagingemployingsteady-stateacquisition(3DFIESTA)、three-dimensionalfastrecoveryfastspinecho(3D-FRFSE)andfastrecoveryfastspine
5、cho(FRFSE)T2WI,andtheoriginalimageswereprocessedwithcurveandmaximumintensityprojection(MIP),observethestructurearoundlacrimalducts,andananlysisthereasonandpositionobstructionoflacrimalducts.AllpatientsunderwentMRIscanningoneweekaftertheexpertendoscopyexamedandtreated,epiphorapatients3DFIESTA、3
6、D-FRFSEandFRFSET2WIresultswerecomparedwithendscopyresults.Results64epiphorasidescomparedwithendoscopyresults,3DFIESTAcandisplaythecauseandpositionofobstruct61sides(95.3%),FRFSET2WIcandisplaycauseandpositionofobstruct53sides(82.8%),3D-FRFSEcannotdisplaythecauseofobstruct,butcandisplaytheobstruc
7、tposition42sides(65.6%),3DFIESTAobviousprecedeFRFSET2WIand3D-FRFSE,thedifferencewasstatisticallysignificant,(x2=14.135,P<0.05).2lacrimaldysfunctionand1stenosisofpunctumallthreetechniquecannotdiagnosis.Conclusion3DFIESTAisobviouspreceded