Diogo M C, Jager M J, Ferreira T A
From the Department of Neuroradiology (M.C.D.), Centro Hospitalar de Lisboa Central, Lisbon, Portugal
Departments of Ophthalmology (M.J.J.).
AJNR Am J Neuroradiol. 2016 Dec;37(12):2334-2339. doi: 10.3174/ajnr.A4890. Epub 2016 Jul 21.
Scleritis is a rare, underdiagnosed vision-threatening condition that can occur isolated or in association with other orbital abnormalities. The etiology of scleritis is mainly inflammatory noninfectious, either idiopathic or in the context of systemic disease. Ultrasonography remains the criterion standard in diagnostic imaging of this condition but might prove insufficient, and studies on the diagnostic value of CT and MR imaging are lacking. We retrospectively analyzed 11 cases of scleritis in which CT and/or MR imaging were performed during the active phase of disease and assessed the diagnostic utility of these techniques. The most important imaging findings of scleritis were scleral enhancement, scleral thickening, and focal periscleral cellulitis. MR imaging is the recommended imaging technique, though posterior scleritis also can be accurately diagnosed on CT. It is important for the radiologist to be acquainted with these findings because being able to diagnose scleritis is of clinical significance and might be vision-saving.
巩膜炎是一种罕见的、诊断不足的威胁视力的疾病，可单独发生或与其他眼眶异常相关。巩膜炎的病因主要是炎症性非感染性的，可为特发性或在全身性疾病背景下发生。超声检查仍是该疾病诊断成像的标准，但可能不够充分，且缺乏关于CT和磁共振成像（MR成像）诊断价值的研究。我们回顾性分析了11例在疾病活动期进行了CT和/或MR成像的巩膜炎病例，并评估了这些技术的诊断效用。巩膜炎最重要的影像学表现为巩膜强化、巩膜增厚和局限性巩膜周围蜂窝织炎。MR成像是推荐的成像技术，不过后巩膜炎也可在CT上准确诊断。放射科医生熟悉这些表现很重要，因为能够诊断巩膜炎具有临床意义，且可能挽救视力。
