眼科 ›› 2013, Vol. 22 ›› Issue (5): 299-303.

• 论著 • 上一篇    下一篇

MRI多颅神经异常与斜视诊断

 满凤媛, 燕飞, 焦永红, 常青林, 鲜军舫, 王振常   

  1. 100730 首都医科大学附属北京同仁医院放射科(满凤媛、燕飞、常青林、鲜军舫);北京同仁眼科中心(焦永红);100050 首都医科大学附属北京友谊医院(王振常)
  • 收稿日期:2013-08-23 出版日期:2013-09-25 发布日期:2013-09-29
  • 通讯作者: 王振常,Email:cjr.wzhch@vip.163.com
  • 基金资助:

    国家自然科学基金(81070762)

MRI study of the abnormality of cranial nerves and diagnosis of strabismus

MAN  Feng-Yuan1, YAN  Fei1, JIAO  Yong-Hong2, CHANG  Qing-Lin1, XIAN  Jun-Fang1, WANG  Zhen-Chang3   

  1. 1. Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; 2. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; 3. Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
  • Received:2013-08-23 Online:2013-09-25 Published:2013-09-29
  • Contact: WANG Zhen-chang, Email: cjr.wzhch@vip.163.com

摘要: 目的 运用MRI评价多条颅神经的形态学异常改变,分析其对斜视病因诊断的价值。设计 回顾性病例系列。研究对象 55例斜视患者。方法 患者行MRI检查,采用3D FIESTA序列,分析脑池段颅神经的MRI表现。主要指标 脑池段颅神经的发育情况。 结果 观察所有55例患者多对颅神经脑池段,发生颅神经异常的MRI表现包括:21例眼外肌纤维化综合征者中,脑池段动眼神经2条未显示,38条动眼神经纤细;16例双侧眼球后退综合征、15例眼外肌纤维化综合征和3例眼-面麻痹综合征中,脑池段外展神经41条未显示,19条纤细,2条脑池段外展神经走行区纤细索条影,1条起始位于脑干中部,1条走行区只见不规则形索条影。3例眼-面麻痹综合征和6例眼球后退综合征患者中,6条面神经、6条听神经、3条舌下神经脑池段未显示。结论 MRI能够清晰显示颅神经脑池段的异常改变,为神经源性斜视的诊断提供客观依据。(眼科,2013, 22: 299-303)

关键词: 颅神经, 斜视, 磁共振成像

Abstract: Objective The abnormalities of cranial nerves in the cistern were displayed by MRI to explore their relationship with strabismus. Design Retrospective case series. Participants Fifty-five patients with strabismus. Methods Fifty-five patients were performed MRI examination, using three dimensional fast imaging employing steady state acquisition (FIESTA) sequence. Cranial nerves in the cistern were observed in oblique-axial and oblique-sagittal planes acquired by MRI. Main Outcome Measures The developmental conditions of the cranial nerves in the cistern. Results All the abnormal cranial nerves in the cistern in 55 cases on MRI were displayed as follow.  In 21 cases of congenital fibrosis of extraocular muscles (CFEOM), 2 oculomotor nerves (CN3)  were absent and 38 were thinner. In 16 cases of Duane syndrome (DS), 15 cases of CFEOM and 3 cases of Mobius syndrome, 41 abducens nerve were absent, 19 were thinner, 2 were chords-like signs, 1 was starting from the middle part of the brainstem, and 1 was substituted by an irregular chords-like signs. Other cranial nerves in the cisterns could not be traced including 6 facial nerves, 6 audible nerves and 3 hypoglosssal nerves in 3  cases of Mobius syndrome (MS) and 6 cases of DS. Conclusion MRI can clearly demonstrate abnormality of cranial nerves in the cistern, which can be used for the diagnosis and differential diagnosis of neurogenic strabismus. (Ophthalmol CHN, 2013, 22: 299-303)

Key words: cranial nerve, strabismus, magnetic resonance imaging