Ординатура / Офтальмология / Английские материалы / Ophthalmic Ultrasound A Diagnostic Atlas 2nd edition_ DiBernardo, Greenberg_2006
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Figure 4–10 Peripapillary traction retinal detachment.
(A) Transverse scan showing posterior vitreous detachment and a focal vitreoretinal adhesion with localized traction retinal detachment at the posterior pole (arrow). (B) Longitudinal scan showing the focal adhesion and the tent-like traction detachment (arrow).
(C) Axial scan showing a broad area of peripapillary adhesion (double arrow) and traction retinal detachment. ON, optic nerve.
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Figure 4–11 Traction retinal detachment (tent-like). (A) Transverse scan showing an extensive area of retinal detachment and a focal vitreoretinal adhesion (arrow). (B) Longitudinal scan showing the focal adhesion (arrow) and the underlying retinal detachment. ON, optic nerve. (C) Standardized A-scan showing the relatively echolucent vitreous (V). Two separate spikes are displayed from the vitreous face (left arrow) and the retina (right arrow).
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Figure 4–12 Traction retinal detachment (“tabletop”). (A) Cross section of a very broad area where the vitreous remains adherent to the retina, causing a localized, bullous traction retinal detachment (arrow). (B) Longitudinal scan showing the same broad area of vitreoretinal adhesion (arrow) and the traction elevation of the retina. (C) Standardized A-scan showing the typical, maximally high spike from the surface of the traction retinal detachment (arrow).
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Figure 4–13 Differentiation. Vitreous Membrane (left), Retinal detachment (right). (A) The arrow on each echogram shows the disc insertion. (B) Notice the smooth consistency of the vitreous membrane versus the retinal detachment and its folded nature. (C) Although the vitreous membrane appears to be dense on the B-scan, it does not produce a maximally high spike on the A-scan. Retinal detachment almost always produces a 100% tall spike. (D) The arrows show the height of the spikes from the vitreous membrane and the retinal detachment as these membranes insert into the fundus in the region of the ora. Vitreous has a weak insertion and retina a very strong insertion in the periphery. (From DiBernardo C. Ultrasonography. In: Regillo CD, Brown GC, Flynn HW. Vitreoretinal Disease: The Essentials. New York: Thieme Medical Publishers; 1999. Reprinted by permission.)
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Figure 4–14 Localized retinal detachment. (A) This patient presented with a small amount of vitreous hemorrhage (V) and a localized, dense, thick, slightly folded inferior retinal detachment (arrow). (B) On A-scan, a maximally high spike is produced by the retinal detachment (arrow).
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Figure 4–15 Localized shallow retinal detachment. (A) Transverse scan showing a localized, shallowly elevated, dense membrane (arrow). (B) Longitudinal scan showing the same membrane (arrow) as it extends to the optic disc (ON). (C) Standardized A-scan showing a steeply rising, maximally high signal produced by the detached retina (arrow).
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Figure 4–16 Localized retinal detachment. (A) Axial image showing localized, posterior retinal detachment (arrow). (B) Transverse view showing slightly folded, shallow elevation (arrow). (C) Longitudinal scan showing disc insertion and area of extent to the periphery (arrow). (D) A-scan showing maximal signal from the detached retina (arrow).
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Figure 4–17 Terson’s syndrome. (A) Transverse scan showing the dispersed hemorrhage (H). The shallowly elevated membrane is not easily distinguished. (B) Longitudinal scan showing dispersed hemorrhage (H) and localized, shallowly elevated membrane (arrow). (C) A tall thin spike is produced by the localized membrane overlying the temporal posterior pole (arrow). (D) Horizontal axial scan showing the thin, shallowly elevated membrane overlying the macula.
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Figure 4–18 Total retinal detachment, open funnel. (A) Transverse scan showing vitreous opacities (V) and a dense, thick, somewhat folded membrane (arrow). (B) Axial scan showing the open funnel and the insertion at the optic disc (ON). (C) Longitudinal image showing the funnel inserting into the optic disc (arrow). (D) A-scan showing the vitreous opacities (V) and the maximally high spike from the detached retina (arrow).
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Figure 4–19 Total retinal detachment, open funnel. (A) Transverse scan showing vitreous opacities (V) and thin, posterior vitreous detachment (left arrow) and a dense, thick, somewhat folded membrane (right arrow). (B) Longitudinal image showing the funnel inserting into the optic disc (arrow). (C) Axial scan showing the open funnel and the insertion at the optic disc, ON. (D) A-scan showing the vitreous opacities (V) and the maximally high spike from the detached retina (arrow).
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Figure 4–20 Subtotal retinal detachment. (A) Longitudinal image showing a closed funnel-shaped membrane inserting into the optic disc (arrow). This membrane appears to be adherent to the fundus near the equator. The peripheral retina remains attached. (B) Axial scan showing the narrow funnel configuration of the retinal
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Figure 4–21 Retinal detachment, closed funnel. (A) The small echolucent circle in the central vitreous cavity is a cross section of a narrow funnel-shaped retinal detachment (arrow). There are extremely dense subretinal opacities.
(B) Longitudinal view showing the echolucent, narrow funnel-shaped membrane (arrow) inserting into the optic disc (ON). (C) Axial B-scan showing the narrow funnel-shaped retinal detachment (arrow) inserting into the optic disc (ON).
(D) Standardized A-scan showing the maximally high spike produced by the retinal detachment (arrow).
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Figure 4–22 Retinal detachment, closed funnel.
(A) Cross section of a narrow funnel-shaped retinal detach-
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Figure 4–23 Retinal cyst. Retinal cyst formation is a common occurrence in a long-standing retinal detachment.
(A) Transverse scan showing mild vitreous opacities and the shallowly elevated retinal detachment (top arrow) with a small cyst (bottom arrow). (B) Longitudinal scan showing retinal detachment with two small cysts (double arrow).
(C) Standardized A-scan shows the relatively flat, vitreous baseline (V) and the maximally high signal obtained from the retinal detachment (R). (D) Standardized A-scan showing the echoes originating from the surfaces of the cyst (CC).
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Figure 4–24 Retinal cyst. (A) Transverse scan showing a large cyst (arrow) within a shallow retinal detachment. There are mild vitreous opacities. (B) Longitudinal scan showing the retina inserting into the optic disc and the cyst located near the equator (arrow).
(C) A-scan showing the echoes produced from the surfaces of the cyst (arrows).
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Figure 4–25 Retinopathy of prematurity. (A) and (B) Longitudinal scans of both eyes from an infant with stage 5 retinopathy of prematurity. The echographic characteristics commonly include dense anterior membrane formation and a narrow, closed funnelshaped retinal detachment. Often large peripheral loops of retina can be seen (arrow).
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Figure 4–26 Retinopathy of prematurity. (A) Longitudinal scan of the left eye of a baby with stage 5 retinopathy of prematurity. Although there has been a previous surgery, there continues to be a narrow funnel retinal detachment. There is also marked, diffuse choroidal thickening (arrow). (B) The contralateral eye, which had no surgical intervention, shows dense anterior membrane formation and a narrow funnel-shaped retinal detachment. There are dispersed opacities beneath the retina (SR).
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Figure 4–27 Retinal pigment epithelial (RPE) detachment. RPE detachments are most often located posterior to the equator.
(A) Transverse scan showing mild vitreous opacities and the typical dome-shaped serous lesion (arrow). (B) Longitudinal scan showing the radial extent of this localized lesion (arrow) and its proximity to the optic nerve (ON). (C) Vertical axial B-scan shows the smooth, blister-like echolucent lesion at the posterior pole (arrow). (D) Standardized A-scan demonstrates a relatively flat, vitreous baseline (V) and a very thin, maximally high spike produced by the surface of the RPE detachment (arrow).