Magnetic Resonance Dacryocystography for Precise Diagnosis of Lacrimal and Perilacrimal Lesions.

IF 5 2区 医学 Q1 OPHTHALMOLOGY
Xuejun Guo, Min Gao, Yulong Qi, Qiao Shi, Qiqiang Li, Mingmei Li, Hongbing Li
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Abstract

Purpose: The accurate determination of the etiology and location of lacrimal passage obstruction is key to treatment. However, the main assessments for lacrimal passage are invasive and have limited value. This study aimed to analyze the causes of obstruction of the lacrimal passage and investigate the diagnostic value of magnetic resonance dacryocystography (MRD).

Methods: Fifty-six patients (69 eyes) with lacrimal disease underwent MRD after lacrimal irrigation. The stenotic site and degree were determined. The accuracies of the diagnoses of lesions at different sites based on MRD and routine clinical assessment were determined and compared, and a noninferiority test was used to verify the values obtained via MRD.

Results: The lesion location determined through lacrimal irrigation was inconsistent with that determined through MRD. The overall accuracy of routine clinical assessment was approximately 79.7% (55 of 69) and that of MRD reached 98.6% (68 of 69). For the lesion location, the clinical misdiagnosis rates were 38.9%, 43.8%, and 63.6% for the lacrimal sac, nasolacrimal duct, and perilacrimal passage, respectively. The MRD and surgical pathology results for the lacrimal sac, nasolacrimal duct, and perilacrimal passage were consistent, except for the lacrimal canaliculus. The P value for the noninferiority of MRD to surgical pathology was 0.32.

Conclusions: MRD is noninvasive and has high value for determining the cause, location, and degree of lacrimal stenosis. Its findings are nearly as accurate as those of surgical pathology. MRD should be recommended over other invasive methods for evaluating lacrimal and prelacrimal lesions.

磁共振泪囊造影对泪道及泪周病变的精确诊断。
目的:准确确定泪道梗阻的病因和部位是治疗的关键。然而,对泪道的主要评估是侵入性的,价值有限。本研究旨在分析泪道阻塞的原因,探讨磁共振泪囊造影(MRD)的诊断价值。方法:56例(69眼)泪道疾病患者在泪道冲洗后行MRD治疗。确定狭窄部位及程度。确定并比较MRD与常规临床评估对不同部位病变诊断的准确性,并采用非劣效性检验验证MRD所得值。结果:泪道冲洗法确定的病变位置与MRD不一致。常规临床评估的总体准确率约为79.7% (55 / 69),MRD的总体准确率达到98.6%(68 / 69)。在病变部位上,泪囊、鼻泪管和泪周通道的临床误诊率分别为38.9%、43.8%和63.6%。除泪小管外,泪囊、鼻泪管和泪周通道的MRD和手术病理结果一致。MRD对手术病理的非劣效性P值为0.32。结论:MRD无创,对泪道狭窄的病因、部位及程度的判断有较高的价值。它的发现几乎和外科病理学一样准确。在评估泪道和泪前病变时,MRD应优于其他侵入性方法。
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来源期刊
CiteScore
6.90
自引率
4.50%
发文量
339
审稿时长
1 months
期刊介绍: Investigative Ophthalmology & Visual Science (IOVS), published as ready online, is a peer-reviewed academic journal of the Association for Research in Vision and Ophthalmology (ARVO). IOVS features original research, mostly pertaining to clinical and laboratory ophthalmology and vision research in general.
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