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目的明确全麻下眼底检查在视网膜母细胞瘤(Rb)诊断中的作用。从而做到早期发现、早期治疗,并且进一步提高患儿眼球保存率。方法回顾性系列病例研究。分析从2011年6月至2014年6月已经确诊为双眼Rb患儿共63人(63眼)。所有患儿均曾行单眼眼球摘除手术。以上患儿均曾行眼B超,双眼眶CT、眼眶核磁共振(MRI)及全麻下双眼眼底检查。采用国际视网膜母细胞瘤眼内分期方法 (International Intraocular Retinoblatoma Classification,IRC)进行具体分期。分析以上各种检查方法针对不同分期视网膜母细胞瘤病例的诊断作用。结果在此63名(63眼)Rb患儿中,经B超检查发现A期2眼,B期12眼,C期7眼,D期5眼;经眼眶CT检查发现A期0眼、B期5眼、C期8眼和D期5眼;经眼眶MRI检查发现A期0眼、B期7眼、C期9眼和D期5眼。经全麻眼底检查发现A期16眼,B期30眼、C期12眼和D期5眼。结论在早期(IRC A期和B期)的Rb病例中,B超、CT和MRI对小肿瘤的发现率较低,随着肿瘤体积的增大,发现率逐渐提高。全麻下眼底检查可以发现各个分期的眼内肿瘤,在Rb的早期诊断中起到了重要的作用。
Objective To clarify the role of fundus examination in the diagnosis of retinoblastoma (Rb) under general anesthesia. To achieve early detection, early treatment, and to further improve the child’s eyeball preservation rate. Methods Retrospective series of case studies. A total of 63 children (63 eyes) who had been diagnosed with binocular Rb from June 2011 to June 2014 were analyzed. All children had single eyeball surgery. All of the above children had undergone eye B ultrasound, bilateral orbital CT, orbital MRI (MRI) and under the eyes of patients under general anesthesia. International staging of retinoblastoma (International Intraocular Retinoblatoma Classification (IRC) for specific staging. Analysis of the above methods for the diagnosis of different stages of retinoblastoma diagnosis. Results In the 63 patients (63 eyes) with Rb, 2 eyes of stage A, 12 eyes of stage B, 7 eyes of stage C and 5 eyes of stage D were detected by B-mode ultrasonography. There were 0 eyes of A 5 eyes, 8 eyes in stage C and 5 eyes in stage D. There were 0 eyes in stage A, 7 eyes in stage B, 9 eyes in stage C and 5 eyes in stage D. After general anesthesia fundus examination, 16 eyes were found in A, 30 eyes in B, 12 eyes in C and 5 eyes in D. Conclusion In the early stages of Rb (stage IRC A and stage B), the detection rates of B-ultrasound, CT and MRI for small tumors are relatively low. As the tumor volume increases, the detection rate gradually increases. Fundus examination under general anesthesia can be found in various stages of intraocular tumors in the early diagnosis of Rb has played an important role.