Graves病眼眶的CT研究

目的 探讨Graves病眼眶的CT特征，评估CT诊断Graves眼病的临床应用价值。方法 回顾性分析了100例（200个眼眶）Graves病的眼眶CT，在CT图像上测定了眼外肌的密度和大小，眼球位置，并与正常值比较，与临床检查结果对照。结果 61例（61％）患者至少有一条增粗的眼外肌：l7例（17%）患者有眼外肌密度减低，显示有脂肪浸润；56例（56％）患者有突眼。75例（75％）患者有突眼或眼外肌异常。75例（75％）患者CT诊断为Graves眼病，临床检查诊断69例（69％），二者联合应用使Graves眼病诊断率提高至84％。结论 Graves眼病的CT特征为眼外肌增粗，密度减低，突眼，泪腺肿大前移，上眼静脉增粗。眼眶CT扫描特别是眼眶的定量CT，评价眼外肌的大小和密度，眼球的位置对诊断Graves眼病是有帮助的。

A study on orbit changes in Graves disease using CT

Objective To study characteristics of orbit changes in Graves disease using CT, and to evaluate clinical value of CT in diagnosis of Graves ophthalmopathy. Method 200 orbits in 100 patients with Graves disease were retrospectively reviewed with CT imaging data. Intensity and size of extraocular muscles and position of the globe were measured on CT images and were compared with normal ranges and clinical data as well. Results 61 (61%) patients had at least one enlarged extraocular muscle, 17 (17%) had decreased intensity of extraocular muscle and the muscle was infiltrated by fat. 56 (56%) had exophthalmos. 75 (75%) had exophthalmos and/or abnormalities in extraocular muscle. 75 (75%) were diagnosed as Graves ophthalmopathy using CT, and 69 (69%) were diagnosed as such using other clinical methods. A collective usage of CT and other clinical methods can improve preciseness of diagnosis as high as 84%. Conclusion Graves ophthalmopathy, in CT imaging, is characterized by enlargement but low intensity of extraocular muscles, exophthalmos, anterior shifting and enlargement of lacrimal gland, widening of superior ophthalmic vein. The followings may be helpful in diagnosing Graves ophthalmopathy as: quantitative CT scan of orbit, size and intensity of ex- traocular muscles and position of the globe.