早產(chǎn)兒視角膜血管的形態(tài)學(xué)臨床量化分析
發(fā)布時(shí)間：2018-08-01 09:31
【摘要】：早產(chǎn)兒視網(wǎng)膜病變（Retinopathy of prematurity, ROP）是影響早產(chǎn)兒視網(wǎng)膜的致盲性眼病之一。ROP的附加性（plus）病變?cè)谝欢ǔ潭壬戏从沉薘OP的嚴(yán)重性及危險(xiǎn)性，表現(xiàn)為后極部視網(wǎng)膜血管的擴(kuò)張和迂曲。本實(shí)驗(yàn)通過(guò)計(jì)算機(jī)軟件量化血管寬度及迂曲度，探討在ROP發(fā)展過(guò)程中視網(wǎng)膜血管的形態(tài)學(xué)改變。 實(shí)驗(yàn)所選60例共120只眼的早產(chǎn)兒眼底圖像，均為于吉林大學(xué)白求恩第一醫(yī)院新生兒科住院并行ROP篩查的早產(chǎn)兒眼底圖像，所有篩查均為同一眼科醫(yī)師應(yīng)用廣角數(shù)碼兒童視網(wǎng)膜成像系統(tǒng)（RetCam Ⅱ）進(jìn)行。其中ROP閾值期及閾值前期的早產(chǎn)兒30例60只眼為ROP組，另外30例60只眼為無(wú)ROP組。所選圖像均為以視盤(pán)為中心的后極部視網(wǎng)膜圖像，借助Image J軟件，選取每張圖像中以視盤(pán)的中心為中心，以視盤(pán)中心與黃斑距離為半徑的圓形區(qū)域，并將圖像分為顳上、顳下、鼻下、鼻上四個(gè)象限，，利用操作者主觀選擇操作和計(jì)算機(jī)軟件的識(shí)別、測(cè)量及計(jì)算功能，測(cè)量最迂曲血管的迂曲度，并通過(guò)計(jì)算機(jī)軟件的放大系統(tǒng)及血管壁描記、銳化功能描記測(cè)量每張圖像中每個(gè)象限距離視盤(pán)中心1個(gè)視盤(pán)直徑長(zhǎng)度的最擴(kuò)張血管的寬度，系統(tǒng)自動(dòng)顯示測(cè)量結(jié)果并均以Excel格式儲(chǔ)存在同一表格中。測(cè)量結(jié)束后分別進(jìn)行組間各象限寬度及迂曲度的比較分析，并行ROP組內(nèi)統(tǒng)計(jì)分析視網(wǎng)膜血管的形態(tài)學(xué)改變。 將所得數(shù)據(jù)行統(tǒng)計(jì)分析可知，1.在所測(cè)量的兩組早產(chǎn)兒眼底圖像中，ROP組視網(wǎng)膜血管的寬度和迂曲度與無(wú)ROP組各象限分別比較均有統(tǒng)計(jì)學(xué)意義（P＜0.001），其中顳上象限視網(wǎng)膜血管的寬度及迂曲度的組間差異最顯著。2.在ROP組內(nèi)，顳上象限與顳下象限視網(wǎng)膜血管的寬度比較無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05），其他各象限之間的血管寬度兩兩比較均有統(tǒng)計(jì)學(xué)意義（P＜0.05）。3.在ROP組內(nèi)，各象限之間的血管迂曲度兩兩比較均無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。 由本實(shí)驗(yàn)可得出如下結(jié)論：1. ROP閾值期及閾值前期的后極部視網(wǎng)膜血管與無(wú)ROP相比，其寬度和迂曲度在各個(gè)象限均發(fā)生了明顯的改變。2. ROP顳側(cè)后極部視網(wǎng)膜血管寬度的改變最明顯，而后極部各個(gè)象限之間血管迂曲度的改變均無(wú)顯著差異。3.早產(chǎn)兒眼底圖像后極部視網(wǎng)膜血管形態(tài)變化的量化分析，能較為客觀的反映ROP篩查中plus病變的判斷并協(xié)助評(píng)價(jià)其嚴(yán)重程度。
[Abstract]:Retinopathy of premature infants (Retinopathy of prematurity, ROP) is one of the blind eye diseases of premature infants. The additional (plus) lesion of ROP reflects the severity and risk of ROP to a certain extent, which is characterized by the dilation and detour of retinal vessels in the posterior pole. The morphologic changes of retinal vessels during the development of ROP were investigated by computer software. The fundus images of 60 premature infants (120 eyes) were selected from Bethune first Hospital of Jilin University and were screened by ROP in pediatrics department of the first Hospital of Jilin University. All screening was performed by the same ophthalmologist using the wide-angle digital retina imaging system (RetCam II). Among them, 30 premature infants with ROP threshold period and 60 eyes with pre-threshold were in ROP group, and 60 eyes without ROP in 30 cases. The selected images were all posterior polar retina images with the center of the disc as the center. With the help of Image J software, the circular region with the center of the disc as the center and the distance between the center of the disc and the macula as the radius was selected for each image, and the images were divided into suprtemporal, subtemporal and subtemporal images. Under the nose and in the four quadrants above the nose, using the operator's subjective selection operation and the recognition, measurement and calculation function of the computer software, the roundness of the most circuitous vessels was measured, and the amplification system of the computer software and the vascular wall drawing were used. Sharpening function is used to measure the width of the most dilated blood vessels in each image, which is one of the diameters of each quadrant from the center of the disc. The system automatically displays the measured results and stores them in the same table in Excel format. At the end of the measurement, the width of quadrant and the degree of detour were compared and analyzed respectively, and the morphological changes of retinal vessels in ROP group were analyzed statistically. From the statistical analysis of the data row, we can see that 1. In the fundus images of preterm infants, there were significant differences in the width and tortuosity of retinal vessels between the two groups (P < 0.001), and the differences of the width and the degree of tortuosity of retinal vessels in the superior temporal quadrant were the most significant among the two groups (P < 0.001). In the ROP group, there was no significant difference in the width of retinal vessels between the superior temporal quadrant and the infratemporal quadrant (P > 0. 05), but there was significant difference between the other quadrants (P < 0. 05). In ROP group, there was no significant difference between the two quadrants (P > 0. 05). From this experiment, we can draw the following conclusion: 1. The width and tortuosity of the posterior polar retinal vessels in the ROP threshold period and prethreshold period were significantly changed in each quadrant compared with those in the absence of ROP. The change of retinal vascular width in posterior temporal pole of ROP was the most obvious, and there was no significant difference in the degree of vessel detour between the different quadrants of the posterior pole of ROP. Quantitative analysis of retinal vascular morphology after fundus imaging of preterm infants can objectively reflect the judgment of plus lesions in ROP screening and help to evaluate the severity of the lesions.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R774.1;R722.6
[Abstract]:Retinopathy of premature infants (Retinopathy of prematurity, ROP) is one of the blind eye diseases of premature infants. The additional (plus) lesion of ROP reflects the severity and risk of ROP to a certain extent, which is characterized by the dilation and detour of retinal vessels in the posterior pole. The morphologic changes of retinal vessels during the development of ROP were investigated by computer software. The fundus images of 60 premature infants (120 eyes) were selected from Bethune first Hospital of Jilin University and were screened by ROP in pediatrics department of the first Hospital of Jilin University. All screening was performed by the same ophthalmologist using the wide-angle digital retina imaging system (RetCam II). Among them, 30 premature infants with ROP threshold period and 60 eyes with pre-threshold were in ROP group, and 60 eyes without ROP in 30 cases. The selected images were all posterior polar retina images with the center of the disc as the center. With the help of Image J software, the circular region with the center of the disc as the center and the distance between the center of the disc and the macula as the radius was selected for each image, and the images were divided into suprtemporal, subtemporal and subtemporal images. Under the nose and in the four quadrants above the nose, using the operator's subjective selection operation and the recognition, measurement and calculation function of the computer software, the roundness of the most circuitous vessels was measured, and the amplification system of the computer software and the vascular wall drawing were used. Sharpening function is used to measure the width of the most dilated blood vessels in each image, which is one of the diameters of each quadrant from the center of the disc. The system automatically displays the measured results and stores them in the same table in Excel format. At the end of the measurement, the width of quadrant and the degree of detour were compared and analyzed respectively, and the morphological changes of retinal vessels in ROP group were analyzed statistically. From the statistical analysis of the data row, we can see that 1. In the fundus images of preterm infants, there were significant differences in the width and tortuosity of retinal vessels between the two groups (P < 0.001), and the differences of the width and the degree of tortuosity of retinal vessels in the superior temporal quadrant were the most significant among the two groups (P < 0.001). In the ROP group, there was no significant difference in the width of retinal vessels between the superior temporal quadrant and the infratemporal quadrant (P > 0. 05), but there was significant difference between the other quadrants (P < 0. 05). In ROP group, there was no significant difference between the two quadrants (P > 0. 05). From this experiment, we can draw the following conclusion: 1. The width and tortuosity of the posterior polar retinal vessels in the ROP threshold period and prethreshold period were significantly changed in each quadrant compared with those in the absence of ROP. The change of retinal vascular width in posterior temporal pole of ROP was the most obvious, and there was no significant difference in the degree of vessel detour between the different quadrants of the posterior pole of ROP. Quantitative analysis of retinal vascular morphology after fundus imaging of preterm infants can objectively reflect the judgment of plus lesions in ROP screening and help to evaluate the severity of the lesions.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R774.1;R722.6
【相似文獻(xiàn)】
相關(guān)期刊論文 前10條
1 董寧;y嚴(yán)
本文編號(hào)：2157141
本文鏈接：http://sikaile.net/yixuelunwen/wuguanyixuelunwen/2157141.html
最近更新
教材專(zhuān)著
