Retinal vein occlusion (RVO) is one of the most common retinal vascular diseases causing blindness, macular edema (ME) is often secondary to it, which causes serious visual impairment to patients. Imaging biomarkers in the changes of retina and choroid of ME secondary to RVO (RVO-ME) have important clinical value in the evaluation of condition, curative effect and visual acuity prediction of patients with RVO-ME. Among them, the disorganization of the retinal inner layers, the integrity of external limiting membrane and ellipsoid zone, and the change of central macular thickness are reliable indexes to evaluate the prognosis of visual acuity; hyperreflective foci, subretinal fluid and intraretinal fluid can be used as important parameters to reflect the level of inflammation; prominent middle limiting membrane and paracentral acute middle maculopathy are the objective basis for judging the degree of retinal ischemia; the changes of choroidal vascular index and choroidal thickness also have potential advantages in evaluating the progress of the disease. Accurately grasp the characteristics of biological markers of RVO-ME related optical coherence tomography is conducive to its reasonable and accurate use in the clinical diagnosis and treatment of RVO-ME, and helpful to further explore the pathogenesis of the disease.
Objective To observe multimodality imaging features of different properties in multifocal choroiditis (MFC). Methods Twenty-eight patients (51 eyes) with MFC were enrolled in this study. There were 10 males and 18 females. The patients aged from 31 to 49 years, with the mean age of (41.5±0.8) years. There were 23 bilateral patients and 5 unilateral patients. All patients underwent best corrected visual acuity (BCVA), slit-lamp biomicroscopy, indirect ophthalmoscopy, fundus colorized photography, infrared fundus photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) examinations. The lesions were classified as active inflammatory lesion, inactive inflammatory lesion, active choroidal neovascularization (CNV) and inactive CNV. The multimodality imaging features of different properties in MFC was observed. Results In fundus colour photography, the boundaries of active inflammatory lesions were blurry, while inactive inflammatory lesions had relatively clear boundaries. Secondary active CNV showed mild uplift and surrounding retinal edema; Secondary active CNV lesions showed mild uplift, retinal edema around the lesion; Secondary non-active CNV had no retinal exudate edema lesions, but had lesions fibrosis and varying degrees of pigmentation. Infrared fundus examination revealed that both active and inactive inflammatory lesions showed a uniform punctate or sheet-like fluorescence. The fluorescence of CNV lesions was not uniform; there was a bright ring around the strong fluorescence. FAF found that active inflammatory lesions showed weak autofluorescence (AF), surrounded by a strong fluorescence ring; inactive inflammatory lesions showed AF loss. Secondary active CNV lesions showed strong AF with a bright ring along the edge, and obscured fluorescence for co-occurred hemorrhagic edema; secondary non-active CNV lesions were strong AF, surrounded by a weak AF ring. FFA revealed that active inflammatory lesions showed weak fluorescence in the early stage, and fluorescence gradually increased in the late stage with slight leakage. Inactive inflammatory lesions showed typical transmitted fluorescence. Fluorescein leakage secondary to active CNV was significant; lesions secondary to inactive CNV showed scar staining. In OCT, the active inflammatory lesions showed moderately weak reflex signals in the protruding lesions under the retinal pigment epithelium (RPE). The inactive inflammatory lesions showed penetrable RPE defects or choroidal scar, it also showed clear RPE uplift lesions with a strong reflection signal. Secondary active CNV showed subretinal fluid retention; secondary non-active CNV showed RPE defects and choroidal scarring. Conclusions Active inflammatory lesions in MFC have blurred boundary, retinal edema and fluorescein leakage in FFA; inactive inflammatory lesions have clear boundary and typical transmitted fluorescence in FFA, and no retinal edema. Secondary active CNV showed subretinal fluid in OCT; and secondary non-active CNV showed RPE defects and choroidal scarring.
探讨64层螺旋CT在诊断冠状动脉起源、走行异常中的价值。 方法: 回顾性分析2007年8月8日至2009年2月1日行冠状动脉64层螺旋CT血管造影检查患者的结果,共635例。对每位患者图像行容积重现(VR)、多平面重建(MPR)、曲面重建(CPR)心脏及冠状动脉,分别观察冠状动脉起始部位、走行情况。结果:635例冠状动脉各段清楚显示,发现冠状动脉起源异常共23例(23/635,3.6%),以起源于主动脉窦上方为主;发现心肌桥共132例(132/635,20.8%),以左冠状动脉前降支(LAD)心肌桥为多,共127例(127/132,96.2%)。结论:64层螺旋CT显示冠状动脉与心脏关系直观、准确,在诊断冠状动脉起源、走行中有重要价值。
ObjectiveTo investigate the specific CT findings of high-risk gastrointestinal stromal tumors (GISTs). MethodsCT findings of 24 patients with high-risk GISTs from August 2009 to March 2014 proved by surgery and pathology were retrospectively reviewed. ResultsTwelve of the high-risk GISTs were from the stomach, 11 from the small intestine (5 from duodenum, 4 from jejunum, and 2 from ileum), and 1 from the rectum. The biggest transverse diameter of the tumor was between 2.5 and 15.0 cm, and 2 were less than 5 cm and 22 of them were over 5 cm. The tumors appeared as irregular in 20 cases, and with indefinite boundary in 21 cases. Twenty-four tumors showed different levels of necrosis and cystic change, 15 showed ulcer, 2 showed perforation with effusion and pneumatosis, and 3 showed calcification. The enhancement of lesion was mostly moderately to markedly inhomogeneous. High-risk small intestinal stromal tumors had more significant enhancement and vessels. Hepatic metastasis in 3 cases was detected. ConclusionCT features of HRGISTs can be found with certain characteristics, which may contribute to the diagnosis.
The lamina cribrosa (LC) is a complicated collagenous meshwork of trabeculae and laminar pores contain capillaries, nerves and neurogliocytes, which provides structural and nutrient support to the retinal ganglion cell axons as they exit the eye. The intraocular pressure causes direct damage or deformation and remodeling of LC, leads to axoplaxmic transport and blood supply disturbance. The preponderance of evidence suggests that LC is the principal site of glaucomatous damage. The development of optic coherence tomography (OCT) technology has improved the imaging quality of deep structures of the optic nerve head and makes it possible to detect LC. The quantitative research indexes of LC structure include LC depth, laminar curvature, laminar thickness, prelaminar tissue, laminar pore, laminar defect and hemodynamics. To improve the understanding of LC structure, explore the characteristics of LC and understand the biomechanical and hemodynamic pathogenesis of glaucoma, which would be contribute to the application of big data research in the diagnosis and treatment of glaucoma.
目的:探讨MRI及多层螺旋CT多平面重建显示胆囊癌对邻近结构侵犯的价值。方法:前瞻性分析18例(CT及MRI各9例)胆囊癌对邻近结构侵犯情况。CT及MRI均包括平扫及增强扫描,CT扫描病例除横断断位外,行冠状位、矢状位重建;MRI病例行横断位、冠状位及矢状位扫描。结果:胆囊癌对邻近结构侵犯的敏感度、特异度、准确度如下:①横断位和矢状位显示邻近肝实质侵犯分别为81.2％、100.0％、83.3％,冠状位分别为87.5％、100.0％、88.9％;②横断位显示胃窦侵犯分别为75.0％、90.0％、83.3％,冠状位及矢状位均分别为75.0％、80.0％、77.7％;③横断位显示十二指肠侵犯分别为70.0％、75.0％、72.2％,冠状位分别为80.0％、75.0％、77.7％,矢状位分别为70.0％、75.0％、72.5％;④横断位和冠状位显示结肠肝曲侵犯均分别为25.0％、85.7％、72.2％,矢状位分别为50.0％、71.4％、66.6％;⑤横断位和冠状位显示胆管侵犯均分别为75.0％、100.0％、83.3％,矢状位分别为66.6％、100.0％、77.7％;⑥横断位、冠状位及矢状位显示邻近腹膜侵犯及淋巴结转移准确度均为66.6％;显示网膜侵犯准确度均为50.0％。结论:横断位、冠状位及矢状位显示胆囊癌对邻近肝实质、胃、十二指肠、胆管侵犯的敏感度、特异度、准确度较高;而显示对结肠肝曲、腹膜、网膜侵犯的准确度较低。
Objective To observe the characteristics of fundus autofluorescence (AF) in short wavelength AF (SW-AF) and Near Infrared AF (NIR-AF), and their relationship with visual fields. Methods Twelve patients (24 eyes) with primary RP were enrolled in this study. The patients included nine males (18 eyes) and three females (six eyes). The patients aged from 15 to 69 years, with a mean age of (35.33plusmn;15.03) years. All the patients were examined for color photography, SW-AF, NIR-AF, visual fields and optical coherence tomography examination. Results There were hyper-AF ring of varying sizes in posterior pole by SW-AF and NIR-AF examinations. The area of hypo-AF which located in SW-AF hyper-AF ring had a positive correlation with the area of hyper-AF in the NIR-AF (r=0.662，P＜0.05). OCT showed that outside the hyper-AF ring, there were disconnected inner segment/outer segment (IS/OS) junction and external limiting membrane, and thinned outer nuclear layer and retinal pigment epithelium. Peripheral retinal osteocytes-like pigmentation showed non fluorescence in SW-AF and NIR-AF. The plaque-like area showed mottled and low fluorescence examined by SW-AF. SW-AF hyper-AF ring had a positive correlation with visual fields (r=0.492，P＜0.05). Conclusions The area of hypo-AF inside of the SW-AF hyper-AF ring is related to visual fields in RP patients. The retinal structures in the hypo-AF area inside of the SW-AF hyper-AF ring, and in the NIR-AF hyper-AF region are normal.
Diabetic macular edema is the leading cause of central vision loss and even blindness in diabetic retinopathy. Compared to FFA, OCT can obtain the high-resolution 3D image quickly, easily to reflect the details of the tissue and realize the quantitative measurement. As a novel technology, OCT angiography (OCTA) can display microvascular structure from different layers of retina and choroid, having its advantage of quantifying the vessel density and the lesion area. By detecting fundus morphology, quantifying and quantitating the retinal vessels and vessel density, the combination of OCT and OCTA could play a guiding role in diagnosis, classification, treatment and prognosis of diabetic macular edema.