中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
2期
161-165
,共5页
危昆桥%魏锐利%马晓晔%李盼
危昆橋%魏銳利%馬曉曄%李盼
위곤교%위예리%마효엽%리반
甲状腺相关眼病%眼外肌%眼眶CT%TAO亚型
甲狀腺相關眼病%眼外肌%眼眶CT%TAO亞型
갑상선상관안병%안외기%안광CT%TAO아형
Thyroid associated ophthalmopathy%Extraocularmuscle%Orbit computed tomography scan%Subtypes of TAO
目的 探讨定量测量TAO患者眼外肌横截面积的可行性,评价其临床意义,根据眼外肌情况讨论TAO亚型的分类.方法 回顾性分析2011年1月至2012年5月在上海长征医院眼科就诊的20例正常对照者、42例TAO患者眼眶CT冠状位平扫图像,利用autoCAD软件测量各眼外肌最粗处横截面积.结果 TAO组下直肌、外直肌、提上睑肌上直肌复合体、内直肌以及眼外肌总横截面积均＞正常对照组,差异有统计学意义(P =0.033,P＜0.05).眼外肌总横截面积与CAS评分呈正相关差异有统计学意义(r =0.791,P＜0.05),与矫正视力呈负相关差异有统计学意义(r=-0.658,P＜0.05).根据眼外肌总横截面积和眼球突出度,可将TAO分为4种亚型:Ⅰ型0例,眶脂肪和眼外肌均不增多;Ⅱ型9例(21.4％),眶脂肪增多为主;Ⅲ型10例(23.8％),眼外肌增粗为主;Ⅳ型23例(54.8％),眶脂肪和眼外肌均增多.结论 TAO患者眼眶CT冠状位平扫定量测量眼外肌横截面积,能够准确反映眼外肌增粗的情况,为评估TAO患者的活动性、区分TAO亚型提供了可靠依据.
目的 探討定量測量TAO患者眼外肌橫截麵積的可行性,評價其臨床意義,根據眼外肌情況討論TAO亞型的分類.方法 迴顧性分析2011年1月至2012年5月在上海長徵醫院眼科就診的20例正常對照者、42例TAO患者眼眶CT冠狀位平掃圖像,利用autoCAD軟件測量各眼外肌最粗處橫截麵積.結果 TAO組下直肌、外直肌、提上瞼肌上直肌複閤體、內直肌以及眼外肌總橫截麵積均＞正常對照組,差異有統計學意義(P =0.033,P＜0.05).眼外肌總橫截麵積與CAS評分呈正相關差異有統計學意義(r =0.791,P＜0.05),與矯正視力呈負相關差異有統計學意義(r=-0.658,P＜0.05).根據眼外肌總橫截麵積和眼毬突齣度,可將TAO分為4種亞型:Ⅰ型0例,眶脂肪和眼外肌均不增多;Ⅱ型9例(21.4％),眶脂肪增多為主;Ⅲ型10例(23.8％),眼外肌增粗為主;Ⅳ型23例(54.8％),眶脂肪和眼外肌均增多.結論 TAO患者眼眶CT冠狀位平掃定量測量眼外肌橫截麵積,能夠準確反映眼外肌增粗的情況,為評估TAO患者的活動性、區分TAO亞型提供瞭可靠依據.
목적 탐토정량측량TAO환자안외기횡절면적적가행성,평개기림상의의,근거안외기정황토론TAO아형적분류.방법 회고성분석2011년1월지2012년5월재상해장정의원안과취진적20례정상대조자、42례TAO환자안광CT관상위평소도상,이용autoCAD연건측량각안외기최조처횡절면적.결과 TAO조하직기、외직기、제상검기상직기복합체、내직기이급안외기총횡절면적균＞정상대조조,차이유통계학의의(P =0.033,P＜0.05).안외기총횡절면적여CAS평분정정상관차이유통계학의의(r =0.791,P＜0.05),여교정시력정부상관차이유통계학의의(r=-0.658,P＜0.05).근거안외기총횡절면적화안구돌출도,가장TAO분위4충아형:Ⅰ형0례,광지방화안외기균불증다;Ⅱ형9례(21.4％),광지방증다위주;Ⅲ형10례(23.8％),안외기증조위주;Ⅳ형23례(54.8％),광지방화안외기균증다.결론 TAO환자안광CT관상위평소정량측량안외기횡절면적,능구준학반영안외기증조적정황,위평고TAO환자적활동성、구분TAO아형제공료가고의거.
Objective To analyzetheextraocular muscle coronal area(EMA) in thyroid associated ophthalmopathy (TAO) and describe different TAO subtypes.MethodsA retrospective study.By using commercial software with a segmentation technique,EMA in 42 patients with TAO and 20 control subjects were calculated from computed tomography (CT) scan.Results The coronal area of inferiorrectus,lateral rectus,superior rectus,medial rectus and total EMA were significantly larger in patients with TAO than the control subjects (P =0.033,P ＜0.001,P ＜0.05).Clinical Activity Score(CAS) and corrected visual acuity were significantly correlated to the total EMA in TAO patients.Four subtypes of TAO could be distinguished:Group Ⅰ,no orbit fat(OF) and extraocular muscles(EM) increase; Group Ⅱ,only OF increase (21.4％); Group Ⅲ,only EM increase (23.8％); Group ⅣV,both OFand EM increase (54.8％).Conclusions Calculating EMA of CT in TAO patients should be taken into consideration.Total EMA is correlated to the CAS and could distinguish the subtypes of TAO.
