目的 研究甲状腺相关眼病累及眼球外肌的核磁共振(MRI)表现及其解剖学基础.方法 回顾性分析36例MRI扫描资料和临床资料完整的甲状腺相关眼病的病例,经临床或B超证实.着重观察眼球外肌受累的范围及程度.结果 36例49眼患者眼眶MRI示双侧或单侧眼球外肌受累,受累频率为:下直肌31条(63.26%),内直肌26条(53.06%),外直肌22条(44.89%),提上睑肌19条(38.77%),上直肌18条(36.73%);眼球外肌厚度明显大于正常眼球外肌(P<0.05);MRI表现中眼球外肌受累占75.51%,球后组织受累占30.61%,眼睑、泪腺受累占28.57%,视神经受累占20.41%.结论 甲状腺相关眼病最常见多条眼球外肌受累,同时受累的还有眼球后的视神经等,MRI能显示解剖细节,指导临床诊断及治疗.
Objective To study the MRI features and anatomic basis of extra-ocular muscles in thyroid associated ophthalmology diseases.Methods Retrospective analysis were conducted on 36 cases of thyroid associated ophthalmology patients with fully detailed magnetic resonance imaging (MRI) and clinical data which were proved clinically or by B ultrasound scan.The analysis emphasized on the damage of extra-ocular muscles.Results MRI results of 36 patients with 49 eyes showed bilateral or unilateral extra-ocular muscles were damaged; the frequency was:31 deprimens oculi muscle(63.26%),26 adducens oculi muscle(53.06%),22 abducens oculi muscle (44.89%),19 levator palpebrae superioris muscle (38.77%),18 musculus religiosus (36.73%); the thickness of extra-ocular muscles was significantly more than the normal (P<0.05); MRI showed thyroid associated ophthalmology damages included changes of extra-ocular muscles (75.51%),retrobulbar tissue (30.61%),eyelids and glandula lacrimalis (28.57%) and optic nerve (20.41%).Conclusion The changes of extra-ocular muscles were the most significant feature of thyroid associated ophthalmology diseases and retrobulbar optic nerve also damaged.MRI can be applied to demonstrate anatomic details and guide the clinical diagnosis and treatments.