永存原始玻璃体增生症彩色多普勒超声诊断的价值及手术效果
Value of color Doppler ultrasonography in diagnosis of persistent hyperplastic primary vitreous and its operative efficacy
穆晓伟 1李彬彬 2费璇 3高莎莎 2吕勇2
作者信息
- 1. 郑州大学第一附属医院超声科,郑州 450052
- 2. 郑州大学第一附属医院眼科 河南省眼科医院,郑州 450052
- 3. 郑州市第二人民医院眼科,郑州 450000
- 折叠
摘要
目的 分析彩色多普勒超声检查在永存原始玻璃体增生症(PHPV)分型中的诊断价值及PHPV不同分型手术的效果.方法 回顾性病例对照研究.收集郑州大学第一附属医院眼科2013 年 1 月至 2020 年 1 月行玻璃体视网膜手术治疗的PHPV 31 例(31 眼)的临床资料.所有患者术前均行二维超声和彩色多普勒血流显像(CDFI)检查,随访2～3 年.依据术后BCVA分为视力改善组与视力无改善组,分析彩色多普勒超声对于PHPV分型的诊断准确度,分析术前超声诊断混合型PHPV的灵敏度、特异度、准确度,单因素分析不同分型的手术效果.结果 31 眼术前彩色多普勒超声检查分为前节型4 眼,混合型20 眼,后节型7 眼;2 眼术前超声检查诊断为后节型者,术中诊断为混合型;1 眼术前超声检查诊断为混合型者,术中诊断为后节型;彩色多普勒超声检查诊断PHPV分型的准确度为 90.32%(28/31),诊断混合型PHPV的灵敏度、特异度、准确度分别为 90.47%、90.90%、93.54%.13 眼术后BCVA改善,18 眼无改善;经术中证实,术后前节型 4 眼均有不同程度BCVA改善,混合型 8 眼BCVA改善,后节型 1 眼BCVA改善,单因素分析显示前节型与后节型、混合型的术后视力效果差异有统计学意义(P=0.010、0.036).结论 彩色多普勒超声检查在PHPV的分型诊断中有重要价值,PHPV不同分型视力结果不同,依据不同分型尽早手术治疗是挽救视力并进一步改善视力的重要方式.
Abstract
Objective To analyze the diagnostic value of color Doppler ultrasonography in the classification of persistent hyperplastic primary vitreous(PHPV)and the result of different PHPV classification operations.Methods This was a retrospective case-control study.The clinical data of 31 eyes of 31 cases of PHPV in the First Affiliated Hospital of Zhengzhou University from Jan.2013 to Jan.2020 were collected.All patients received vitreoretinal surgery and were examined by two-dimensional ultrasound and color Doppler flow imaging(CDFI)before surgery.The follow-up time was 2-3 years.The best corrected visual acuity(BCVA)was recorded,and patients were divided into the visual acuity improvement group and visual acuity non improvement group,based on postoperative BCVA.The diagnostic accuracy of color Doppler ultrasound for PHPV classification was analyzed,and the sensitivity,specificity and accuracy of preoperative ultrasonic diagnosis of mixed PHPV were analyzed,and the differences in surgical results of different classification were univariate analyzed.Results By referring to color Doppler ultrasonography before operation,the 31 eyes fell into 3 types,i.e.,anterior segment type(4 eyes),posterior segment type(7 eyes)and mixed type(20 eyes).Two eyes were diagnosed as posterior segmental type by ultrasonography before operation but then re-diagnosed as mixed type during operation.One eye was diagnosed as mixed type by ultrasonography before surgery but then re-diagnosed as posterior segment type during surgery.The accuracy of color Doppler ultrasonography was 90.32%(28/31),and the sensitivity,specificity and accuracy of mixed PHPV were 90.47%,90.90%and 93.54%,respectively.BCVA improved in 13 eyes and stayed with no improvement in 18 eyes.After operation,it was confirmed that all 4 eyes of anterior segment type had improved BCVA with varied degrees,8 eyes of mixed segment type had improved BCVA,and 1 eye of posterior segment type had improved BCVA.Univariate analysis showed that there were statistically significant differences in postoperative visual acuity between anterior segment,posterior segment and mixed types(P=0.010,0.036).Conclusion Color Doppler ultrasonography plays an important role in the diagnosis and classification of PHPV.The prognosis of PHPV is different.Early surgical treatment according to different PHPV classification is an important way to save and improve vision.
关键词
永存原始玻璃体增生症/超声检查,多普勒,彩色/视力Key words
Persistent hyperplastic primary vitreous/Ultrasonography,doppler,color/Visual acuity引用本文复制引用
出版年
2024
NETL
NSTL
万方数据