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眼内金属异物:计算机断层扫描的作用

Intraocular metallic foreign body: role of computed tomography.

作者信息

Pokhraj P Suthar, Jigar J Patel, Mehta Chetan, Narottam A Patel

机构信息

Resident, Department of Radiology, S.S.G. Hospital, Medical College , Vadodara, Gujrat, India .

MBBS Student, Medical Institute & Research Center, Suamandeep Vidhyapeeth University , Waghodia, Vadodara, Gujrat, India .

出版信息

J Clin Diagn Res. 2014 Dec;8(12):RD01-3. doi: 10.7860/JCDR/2014/9949.5271. Epub 2014 Dec 5.

Abstract

Orbital foreign bodies remain a serious diagnostic problem, despite development of diagnostic imaging techniques. Non-metallic orbital foreign body will not be detected in routine x-ray. Here we are presenting a case of 32-year-old male presented with acute pain in left eye immediately after he had been pounding a metal object with a metal chisel. Following this event patient develop blurring of vision in left eye with tearing. Patient's vision in left eye was found to be hand motion with conjunctiva mildly injected, left corneal central 1 mm Seidel-negative full-thickness laceration and dense traumatic cataract was seen on ocular examination. Dilated fundus examination of left eye was not possible due to traumatic cataract. Vitreous hemorrhage, vitreous detachment and a echogenic foreign body present in posterior segment in B-Scan sonography. Well-defied hyperdense foreign body producing streak artifacts with vitreous hemorrhage was seen in the posterior chamber of left eyeball in CT orbit. The patient was diagnosed with a corneal laceration, traumatic cataract, vitreous hemorrhage and a metallic intraocular foreign body. He was brought to the operating room urgently for corneal laceration repair, pars plana vitrectomy, lensectomy, and removal of the metallic intraocular foreign body done.

摘要

尽管诊断成像技术有所发展,但眼眶异物仍然是一个严重的诊断难题。非金属眼眶异物在常规X线检查中无法被检测到。在此,我们报告一例32岁男性病例,该患者在用金属凿子敲击金属物体后立即出现左眼剧痛。在此事件后,患者左眼出现视力模糊并伴有流泪。眼部检查发现患者左眼视力仅为手动,结膜轻度充血,左眼角膜中央有1毫米Seidel阴性的全层裂伤,可见致密的外伤性白内障。由于外伤性白内障,无法对左眼进行散瞳眼底检查。B超检查显示玻璃体出血、玻璃体脱离,眼后段有一强回声异物。眼眶CT显示左眼球后房有一界限清晰的高密度异物,伴有玻璃体出血产生的条纹伪影。该患者被诊断为角膜裂伤、外伤性白内障、玻璃体出血和金属性眼内异物。他被紧急送往手术室进行角膜裂伤修复、经平坦部玻璃体切除术、晶状体切除术以及取出金属性眼内异物。

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