眼球內異物之定位－比較Comberg氏法，超音波及電腦斷層掃描

Localization of Intraocular Foreign Body: A Comparison of Comberg's Technique, Ultrasonography and CT Scan

劉榮宏(Jorn-Hon Liu) ； 蕭忠浩(Chung-Ho Shiao) ； 黃書紳(Shu-Shen Huang)

《中華民國眼科醫學會會刊》 24卷2期 (1985/05) Pp. 340-343

https://doi.org/10.30048/ACTASOS.198505.0058

摘要

比較Comberg氏檢查法、超音波及電腦斷層掃描對眼球內異物定位的準確性，以26例眼球內異物傷同時有光介質混濁之病例，連續施以三種不同之定位檢查，並於手術後判定其準確度。結果發現異物位於玻璃體腔較近中央時，三者都有相當高的診斷率，Comberg氏法在10例中9例正確(90%)，超音波法10/10(100%)，電腦斷層掃描10/10(100%)。異物在視網膜前之5例中，Comberg氏法都不能確定其位置，超音波法4/5(80%)正確，電腦斷層掃描5/5(100%)。異物嵌在眼球壁之6例中，Comberg氏法都不能確定，超音波法3/6(50%)正確，電腦斷層掃描6/6(100%)。異物在眼窩內之5例中，Comberg氏法3/5(60%)正確，超音波則無法測知，電腦斷層掃描5/5(100%)正確。電腦斷層掃描明確地顯示出眼球壁的內外面，故對任何位置的異物都能正確地定位，是最方便而準確的方法。超音波能顯示眼球壁的內面，並同時測知視網膜及玻璃體的病變，故可以輔助電腦斷層掃描的不足。著者建議對眼球內異物病例使用電腦斷層掃描作最精確的定位，同時用超音波對眼球內部的病變作最詳盡的檢查，進而施與最適當的治療。

並列摘要

The purpose of this study is to compare the accuracy and reliability of Comberg's technique, of ultrasonography and of CT scan for IOFB localization. Twenty-six cases of ocular penetrating injury by the missile with cloudy media were examined with all three methods. The accuracy of each examination was determined by the detection of a foreign body during the vitrectomy procedure or orbital exploration. The results showed that all three methods have a high degree of accuracy when the foreign bodies are in the vitreous cavity close to the center. With Comberg's method, 9 cases out of 10 (90%) were localized correctly, with ultrasound 10 out of 10 (100%) and with CT scan 10 out of 10 (100%). For 5 cases of preretinal foreign body, Comberg's method failed to indicate whether the foreign bodies were in or out of the globe. Ultrasound, however, localized correctly in 4 cases out of 5 (80%) and CT scan 5 out of 5 (100%). For 6 cases of a mural foreign body, Comberg's method failed to pinpoint an exact location, while ultrasound made an accurate localization in 3 out of 6 (50%) and CT scan 6 out of 6 (100%). When the foreign bodies were in the orbit, as in the cases of double perforation, Comberg's method was able to localize in 3 cases out of 5 (60%), CT scan in 5 out of 5 (100%), and ultrasound in none.
The advantages of CT scan are that it displays the global wall clearly and is able to determine the location of a foreign body in any place. Ultrasound also displays the global wall m addition to the vitreal and retinal changes. However, it has some difficulty in localizing the pre-retinal and mural foreign bodies in the presence of thick fibrous tissue. Also, an orbital foreign body can be out of view in ultrasound examination. The authors suggest that all suspected IOFB be examined with both CT scan and ultrasound to obtain maximal information and to offer the patient the best treatment.

並列關鍵字

intraocular foreign body ； Comberg's method ； ultrasonography ； computerized tomography