【摘要】 目的 探讨眼外伤所致眼内病理膜的彩色多普勒超声诊断特点。方法 回顾性病例研究。选择2013年1-12月因眼外伤行眼部彩色多普勒超声检查的患者1 156例（1 162眼），对其彩色多普勒超声诊断特点进行总结和分析，部分病例经手术确定诊断，判断彩色多普勒超声诊断的准确性。结果 1 156例（1 162眼）的超声诊断包括玻璃体积血（1 071 眼）、眼内炎（78眼）、玻璃体后脱离（624眼）、视网膜脱离（521眼）、脉络膜脱离（221眼）、脉络膜上腔积血（117眼）等。眼外伤所致的玻璃体内膜状病变的彩色多普勒超声诊断特点为单一疾病表现典型，但多数患者存在2种或2种以上病变。应用彩色多普勒超声检查，在参考二维超声检查结果的同时，根据视网膜、脉络膜的血供特点，可以在错综复杂的眼内条带状回声中分辨出脱离的视网膜和脉络膜，为手术和治疗提供可靠的依据。本组部分病例经手术治疗。总体超声诊断与临床和手术诊断的符合率为99.1%。结论 应用彩色多普勒超声检查眼外伤所致玻璃体内膜状病变是一种经济、简便、无创、可重复性好的诊断方法，根据视网膜和脉络膜的血流特征分析方法，可以提高超声诊断的准确性。
【关键词】 眼损伤； 眼内病理膜； 超声诊断，多普勒，彩色
DOI：10.3760/cma.j.issn.1674-845X.2014.11.004
作者单位：100730 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室
通信作者：杨文利，Email：yangwl_tr@163.com
Color Doppler flowimaging for the diagnosis of damage to intraocular membranes from oculartrauma
Li Dongjun， Chen Wei， Wang Ziyang， Yang Wenli. Beijing Tongren Eye Centre，Beijing Tongren Hospital， Capital Medical University， Beijing Ophthalmology & Visual Sciences Key Laboratory， Beijing 100730， China
Corresponding author： Yang Wenli，Email： yangwl_tr@163.com
【Abstract】 Objective To investigate thecharacteristics of damage to intraocular membranes from ocular trauma usingcolor Doppler flow imaging （CDFI） for diagnosis. Methods Weretrospectively studied 1 162 eyes of 1 156 patients who sustained ocularinjuries from January 2013 to December 2013. CDFI was used to detect damage toocular membranes. The surgical diagnosis was also reviewed. Results Among 1 162 eyes of 1 156 patients， vitreous hemorrhage presented in 1 071 eyes， endophthalmitis presented in 78 eyes， andposterior vitreous detachment presented in 624 eyes. There were 521， 221 and 117 eyes with retinal detachment，choroidal detachment and choroidal hemorrhage，respectively. While trauma to intraocular membranes is typically associatedwith a single injury identified with CDFI， most of thepatients suffered from various injuries. Color Doppler flow imaging detectedthe damaged tissues with 2D images. Moreover， theimaging can analyze the retina and choroid blood flow to help distinguishretinal or choroidal detachment. In this study， 99.1%of the ultrasound diagnoses matched the clinical and surgical diagnoses.Conclusion Color Doppler flow imaging isan economical and simple way to detect intraocular membrane injury from oculartrauma. It is also noninvasive and repeatable. The use of retinal and choroidalblood flow analysis can increase the detection rate of intraocular membraneinjury from ocular trauma.
【Key words】 Eye injury； Intraocular membrane； Ultrasound diagnosis，Doppler，color
