文献摘译InjuriesoftheGl

Introduction

Eyeinjuriesaccountforapproximately3%ofallemergencyroomvisitsintheUnitedStates(1,2).TheWorldHealthOrganizationestimatesthateyeinjuriesresultinblindnessinabout1.6millionpeopleandunilateralblindnessordecreasedvisioninalmost19millionpeopleeachyear(3).Thus,itisapparentthateyeinjuriesareasignificantcauseofdisability,especiallyinyoungmen,inwhomoculartraumaispredominant(3–6).

眼外伤约占美国急诊总量的3%。WHO统计表明，每年约万人因眼球外伤而失明，约万人单侧失明或视力减弱。因此，眼球外伤史致残的重要原因之一，尤其是在年轻人。

Theoverallprevalenceoftrauma-relatedeyeinjuriesisapproximately2%–6%,withasmanyas97%ofcasesresultingfromblunttrauma(7,8).Commonmechanismsofinjuryincludemotorvehicleaccidents,sports-relatedaccidents,industrialaccidents,falls,andviolenttrauma(1,2,7–9).Patientswithtrauma-relatedfacialfracturesareatanincreasedriskforassociatedeyeinjuries,andtheincidenceofvisionlossandblindnessrelatedtofacialfracturesmaybeashighas10.8%(7,9–12).Ocularinvolvementmayalsobeseeninasmanyas84%ofpatientswithheadinjuries(13).Forthisreason,thepresenceoffacialfracturesorheadinjuriesshouldpromptathoroughassessmentforpotentialocularinjury.

2%-6%的创伤可引起眼球损伤，其中97%为钝性伤。常见的损伤机制包括车祸、体育运动、工业意外、高层坠落、暴力创伤。面部外伤的患者中，高达10.8%可发生视力减退和失明。另外头外伤的患者中，也有约84%合并眼部受累。因此，面部外伤和头外伤的患者，需全面评估潜在的眼球损伤情况。

Urgentophthalmologicevaluationisimportantforpromptandappropriatemanagementofocularinjuries(10,11).However,becauseofsurroundingperiorbitalsoft-tissueswellingandotherassociatedinjuries,physicalexaminationoftheglobemaybedifficultinthesettingofacutetrauma,physicalexaminationoftheglobeandpatientcooperationmaybelimitedbyunresponsiveness,alteredmentation,orsedation.Inthepresenceofsuchfactors,imagingisnecessarytoassesstheextentofinjuries.Radiologistsmaybethefirsttoidentifyanyinjuriesoftheglobe;thus,knowledgeofthevariousocularinjuriesandtheirimagingappearancesiscrucialinmakingaccuratediagnosestoguideproperpatienttreatment.Inthisarticle,wediscussthenormalocularanatomy,thevariouspatternsofocularinjuryandtheirimagingappearances,andpotentialmimicsofinjury.

紧急眼科检查评价眼外伤非常及时有效。但由于眼科周围组织肿胀，合并周围其他损伤，急性外伤中眼部体格检查难以进行，且患者可能由于无应答、心理状态改变、镇静等原因所致的不配合。由于以上种种原因，影像学检查评估损伤程度是非常重要的。放射科医生首先要确定眼球的各种损伤，因此，需要了解各种眼外伤及其影像学表现，以指导制定合适的治疗方法。本文中，将讨论正常眼部解剖、各种眼外伤及其影像学表现，潜在的损伤。

NormalAnatomy

图1AC:前房C:角膜CB：睫状体Ch：脉络膜I：虹膜L:晶状体ON：视神经PS：玻璃体R：视网膜Sc：巩膜

图2LR：外直肌MR：内直肌

ImagingModalities

Atourinstitution,orbitalCTimagesareacquiredhelically

fromthefrontaltothemaxillarysinuseswiththefollowingparameters:kVp,mAs,1.25-mmsectionthicknesswith1.25-mmintervals,andapitchof0..Imagesarereconstructedinsofttissueandbonekernelsinbothaxialandcoronalplanes.

扫描方法：额部至上颌窦横断位扫描，kVp,mAs,层厚1.25mm，层间隔1.25mm，螺距0.，图像以骨窗和软组织窗重建呈横断位和冠状位。

AnteriorChamberInjuries前房损伤

Anteriorchamberinjuresareoftendifficulttodiagnoseradiologically,andareusuallymorereadilyidentifiedatclinicalexamination.Commoninjuriesinvolvingtheanteriorchamberincludecorneallacerations（角膜撕裂伤）andhyphema（前房积血）.

图3：角膜全层撕裂，虹膜脱出

图4.前房积血

LensInjuries晶状体损伤

Thelensissurroundedbyacapsuleandsuspendedbyradiallyorientedzonularfibersthatareconnectedtotheciliarybody.Bluntforcethatisappliedtotheglobeintheanterior-posteriordirectionredistributesintheequatorialdirection,whichmaycausetheattachmentsofthezonularfibersonthelenstostretchandpossiblytear.Thismechanismcanresultinpartialor







































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