磁共振成像技术3DFIESTA序列对溢泪病因分析的临床.docVIP

磁共振成像技术3D FIESTA序列对溢泪病因分析的临床应用价值 [摘要]目的 探讨应用MRI泪道成像技术3D FIESTA序列对明确溢泪病因的临床应用价值。方法 溢泪患者50例（溢泪64侧、正常36侧）行泪道MRI检查。检查前分四次向双眼结膜囊滴入0.9%的NaCl注射液，扫描序列为三维快速平衡稳态序列（3D FIESTA）、三维快速恢复快速自旋回波序列（3D-FRFSE）和快速恢复快速自旋回波（FRFSE T2WI），并将3D FIESTA、3D-FRFSE序列的原始图像做后处理及三维重建，观察溢泪患者泪道显示情况，并分析泪道阻塞的部位与原因。所有溢泪患者MRI检查后1周内进行内窥镜检查和治疗，将3D FIESTA、3D-FRFSE和FRFSE T2WI序列所得出的诊断与内窥镜检查结果进行对照分析。结果 64侧溢泪泪道与内窥镜结果进行对照，3D FIESTA序列能显示梗阻位置与病因61侧（95.3%），FRFSE T2WI显示53侧（82.8%），3D-FRFSE序列不能分析梗阻原因、显示梗阻部位42侧（65.6%），3D FIESTA序列诊断正确率显著高于FRFSE T2WI和3D-FRFSE序列，差异有统计学意义（x2=14.135，P0.05）。有2侧泪道功能不全和1侧泪点狭窄以上三种检查均未做出明确诊断。结论 3D FIESTA序列对于溢泪病因分析明显优于3D-FRFSE序列和FRFSE T2WI序列，对于帮助临床选择治疗方案有着重要的作用。 [关键词] 溢泪；磁共振成像；3D FIESTA Clinical application value of MR dacryocystography technique 3D FIESTA to analysis the cause of epiphora [Abstract]Objective To explore the value of MR dacryocystography technique 3D FIESTA to analysis the cause of epiphora.Methods 50 epiphora patients (64 epiphora sides and 36 healthy sides)underwent MRI lacrimal examination。Insillation of 0.9%NaCl saline four times to bilateral conjunctival sac before the exam,the scanning sequences included three-dimensional fast imaging employing steady-state acquisition(3D FIESTA)、three-dimensional fast recovery fast spin echo(3D-FRFSE) and fast recovery fast spin echo(FRFSE) T2WI，and the original images were processed with curve and maximum intensity projection(MIP),observe the structure around lacrimal ducts,and ananlysis the reason and position obstruction of lacrimal ducts.All patients underwent MRI scanning one week after the expert endoscopy examed and treated,epiphora patients 3D FIESTA、3D-FRFSE and FRFSE T2WI results were compared with endscopy results.Results 64 epiphora sides compared with endoscopy results,3D FIESTA can display the cause and position of obstruct 61sides(95.3%),FRFSE T2WI can display cause and position of obstruct 53 sides(82.8%),3D-FRFSE can not display the cause of obstruct ,but can display the obstruct position 42 side