眼外肌肥大在電腦斷層攝影之鑑別診斷

Differential Diagnosis of Extraocular Muscle Enlargement in CT Scan

宋湖仙(Hu-Shien Song) ； 高玲玉(Ling-Yuh Kao) ； 莊蕙蓴(H. C. Chuang)

《中華民國眼科醫學會會刊》 26卷2期 (1987/05) Pp. 539-543

https://doi.org/10.30048/ACTASOS.198705.0096

摘要

在電腦斷層掃描片中出現眼外肌肥大的病因，最多為以下三類疾病：甲狀腺性眼窩症(Dysthyroid Ophthalmopathy)、頸動脈海綿竇瘻管(Carotid-Cavernous Fistula)以及眼肌炎(Idiopathic Myositis)。本文分析27例眼外肌肥大的電腦斷層掃描片，討論三類疾病的特徵。眼外肌肥大之最常見原因為甲狀腺性眼窩症，它的主要特徵是多條肌肉不對稱的受侵犯，眼肌病變不會波及肌腱，眼窩內的具它組織，鮮少變化。頸動脈海綿竇瘻管可見患眼的各眼肌呈均等的肥大，並有明顯擴張的上眼靜脈(Superior Ophthalmic Vein)。眼肌炎的變化最難預料，但若有眼肌肥大呈不規則外緣及肌腱肥大的情形，而且臨床上對類因醇藥物反應迅速者，眼肌炎的可能性最高。

並列摘要

Enlarged extraocular muscles can be detected in three different diseases with characteristic manifestations. Dysthyroid ophthalmopathy are mainly manifestated as extraocular muscle enlargement with little change of surrounding tissue. Inferior rectus and medial rectus are most commonly involved. Muscle tendons are spared from disease. Carotid-cavernous fistula causes congestive hypertrophy of all muscles of the lesion eye. Engorged superior ophthalmic vein is often detected in these cases. Idiopathic myositis is diagnosed by exclusion. Irregular shape and indistinct margin of the enlarged muscle favors the diagnosis of idiopathic myositis. High-resolution CT scanning is helpful especially in differentiating unilateral exophthalmos without apparent clinical diagnosis. Despite that, careful assessment of clinical signs and CT findings are both important for definite diagnosis.

並列關鍵字

computed tomography ； dysthyroid ophthalmopathy ； carotia-cavernous fistula ； idiopathic myositis