背景:我们的研究旨在比较泪溢患者的非侵入性成像,如局部计算机断层扫描泪囊造影(CTD)和局部磁共振泪囊造影(MRD)。
目的:评估螺旋CTD期间局部造影剂和MRD期间局部盐水以显示鼻泪引流系统(NLDS)阻塞的实用性。
方法:对20名鼻泪管阻塞患者进行2年观察。10名参与者接受CTD,其他10名参与者接受MRD。由两名放射科医生分析图像。参与者还被问及对比材料与盐溶液的不适程度。
结果:在CTD和MRD上均可见NLDS。根据κ统计,两个观察者之间的一致性很好(κ值>0.81)。CTD多平面和3D图像可以精确诊断阻塞点,MRD不需要任何对比材料,并显示出梗阻点.与局部对比剂相比,盐水对患者更舒适(P<0.05)。
结论:局部CTD和MRD是非侵入性技术,与常规侵入性插管泪囊造影相比,可以显示NLDS中阻塞的程度和水平。CTD可用于可视化阻塞点和较小的引流结构。然而,它是对镜头的电离辐射源。MRD的好处是它不需要对比或辐射;然而,在描绘骨骼解剖结构和较小的引流结构方面较差。最后,患者对生理盐水的耐受性优于局部对比剂。
BACKGROUND: Our study aims to compare non-invasive imaging such as topical computed tomography dacryocystography (CTD) and topical magnetic resonance dacryocystography (MRD) in patients with epiphora.
OBJECTIVE: To evaluate the practicability of topical contrast media during helical CTD and topical saline during MRD to reveal obstruction in the nasolacrimal drainage system (NLDS).
METHODS: Twenty participants with nasolacrimal duct obstruction were observed for two years. Ten participants underwent CTD and the other 10 participants underwent MRD. Images were analyzed by two radiologists. Participants were also asked about the level of discomfort of the contrast material versus the saline solution.
RESULTS: The NLDS was seen on both CTD and MRD. Very good agreement between the two observers (κ value > 0.81) was seen according to the κ statistics. CTD multiplanar and 3D images allowed for precise diagnosis of the point of obstruction whereas, the MRD did not require any contrast material and showed the point of obstruction. Saline was more comfortable for the patients than topical contrast (P < 0.05).
CONCLUSIONS: Topical CTD and MRD are non-invasive techniques that can visualize the degree and level of obstruction in the NLDS than conventional invasive cannulation dacryocystography. CTD is useful in visualizing the point of obstruction and smaller drainage structures. However, it is a source of ionizing radiation to the lens. The benefit of MRD is that it requires no contrast or radiation; however, it is poor in depicting the bone anatomy and smaller drainage structures. Finally, saline was better tolerated by patients than topical contrast.