摘要目的 探讨CT泪囊造影检查方法在儿童泪道疾病中的诊断价值.方法 回顾性系列病例研究.收集2009年10月至2011年10月在北京儿童医院就诊的300例(395只眼)泪道疾病患儿CT泪囊造影检查的资料并进行分析.结果 在240例(326只眼)先天性泪道阻塞患儿中,根据CT泪囊造影显示的阻塞位置,发现阻塞于泪总管或泪总管以上部位的有6只眼(1.8％),阻塞于泪囊部位的有38只眼(1 1.7％),阻塞于泪囊与鼻泪管交界部位的有213只眼(65.3％),阻塞于鼻泪管末端的有69只眼(21.2％).对于单侧先天性泪道阻塞,CT泪囊造影发现阻塞侧骨性鼻泪管较健侧出现明显扩大.对外伤性泪道阻塞患儿,其可以清晰显示受伤侧泪囊窝骨质破坏及泪道软组织损伤情况.同时,CT泪囊造影也可进行先天性泪囊突出、先天性骨性鼻泪管发育异常及泪囊憩室的辅助检查.结论 CT泪囊造影能够为多种儿童泪道疾病提供有力的诊断、治疗及研究依据,因此其可以作为一种重要的辅助性儿童泪道影像学检查方法应用于临床.

abstractsObjective To explore the application value of computed tomography (CT) dacryocystography in children lacrimal diseases.Methods Retrospective case series.The results of CT dacryocystography in 300 children (395 eyes) with lacrimal diseases from October 2009 to October 2011 in Beijing Childreu Hospital were analyzed retrospectively.Results Among 240 children (326 eyes) with congenital nasolacrimal duct obstruction,the sites of obstruction were in the common canaliculus or upper positiou in 6 eyes(1.8％),in the lacrimal sac in 38 eyes(11.7％),at the borderline between lacrimal sac and nasolacrimal duct in 213 eyes(65.3％) and at the terminal of nasolacrimal duct in 69 eyes (21.2％).CT dacryocystography could display the obstruction position of lacrimal duct in congenital nasolacrimal duct obstruction.In uuilateral congenital nasolacrimal duct obstruction,CT dacryocystography indicated that nasolacrimal canal in affected side were much larger than that in normal side.It could show the destruction of lacrimal soft tissue and the fossa of lacrimal sac in traumatic lacrimal duct obstruction.CT dacryocystography was also the main subsidiary method for the diagnosis of congenital dacryocystocele,congenital nasolacrimal canal agenesis and lacrimal sac diverticula.Conclusions CT dacryocystography can provide important aspects for the diagnosis and treatment of children lacrimal diseases.Therefore,it can be used as an important image examination method in children with lacrimal diseases.