葡萄膜转移癌的超声诊断特征分析

发布时间：2018-06-26 18:23

本文选题：葡萄膜转移癌 + 彩色多普勒超声　；参考：《肿瘤影像学》2016年04期

【摘要】：目的:探讨葡萄膜转移癌的超声诊断特征。方法:回顾性分析2012年1月—2016年11月北京同仁医院眼科收治的葡萄膜转移癌患者25例(29只眼),分析超声检查中病变的位置、形态、隆起高度、基底-高度比率、内回声及其特点、有无挖空征和脉络膜凹陷征、有无继发视网膜脱离和玻璃体混浊、彩色多普勒血流成像(color Doppler flow imaging,CDFI)检查病变内血流情况等。其中14例(14只眼)行超声造影检查,并进行时间-强度曲线分析。结果:25例(29只眼)葡萄膜转移癌患者,累及左眼8例(32.0%)、右眼13例(52.0%)、双眼4例(16.0%);位于虹膜睫状体4只眼(13.8%)、脉络膜25只眼(86.2%);7只眼(24.1%)病变超声表现为扁平隆起回声、7只眼(24.1%)为半球形隆起回声、15只眼(51.7%)病变表面回声不规则(可见切迹或呈波浪状);病变隆起高度平均为(3.5±2.2)mm,基底-高度比率平均为3.7±2.1;27只眼(93.1%)病变内回声表现为低于相邻眶内组织的低回声;2只眼(6.9%)挖空征阳性,5只眼(17.2%)脉络膜凹陷征阳性;21只眼(72.4%)出现继发视网膜脱离,11只眼(38.0%)合并玻璃体混浊。CDFI检查显示,21只眼(72.4%)病变内可见树枝状血流信号。14例(14只眼)行超声造影检查,其中13只眼(92.9%)病变的时间-强度曲线表现为快进快出型。结论:葡萄转移癌超声检查有一定的特征性表现,可为临床提供可靠的诊断和鉴别诊断依据。
[Abstract]:Objective: to investigate the characteristics of ultrasonic diagnosis of uveal metastatic carcinoma. Methods: Twenty-five patients (29 eyes) with metastatic uveal carcinoma admitted to Tongren Hospital from January 2012 to November 2016 were analyzed retrospectively. The location, shape, height of protuberance, ratio of basal to height in ultrasound examination were analyzed. The internal echo and its characteristics, whether there are hollowness sign, choroidal depression sign, secondary retinal detachment and vitreous opacity, color Doppler flow imaging and CDFI are used to examine the blood flow in the lesions. Among them, 14 cases (14 eyes) were examined by contrast-enhanced ultrasonography, and time-intensity curves were analyzed. Results 25 cases (29 eyes) with metastatic carcinoma of the uveal membrane, 8 cases (32.0%) were involved in left eye, 13 cases (52.0%) in right eye, 4 cases (16.0%) in binocular, 4 eyes (13.8%) were located in iris and ciliary body, 7 eyes (24.1%) were located in iris ciliary body, 7 eyes (24.1%) were located in choroid body, 7 eyes (24.1%) showed flattened protuberance echo, 15 eyes (51.7%) were surface lesion of hemispherical eminence echo. The mean height of the lesion was (3.5 卤2.2) mm and the ratio of basal to height was 3.7 卤2.1% (93.1%) in 27 eyes (93. 1%), which was lower than that in 2 eyes (6. 9%) with low echo in adjacent orbital tissues. In 5 eyes (17.2%), 21 eyes (72.4%) had secondary retinal detachment, 11 eyes (38.0%) had secondary retinal detachment and vitreous opacity. CDFI examination showed that 21 eyes (72.4%) had dendritic blood flow signal in 21 eyes (72.4%). In 13 eyes (92. 9%), the time-intensity curve was fast in and out. Conclusion: ultrasonic examination of grape metastatic carcinoma has some characteristic features, which can provide reliable basis for diagnosis and differential diagnosis.
【作者单位】：首都医科大学附属北京同仁医院北京同仁眼科中心眼内肿瘤诊治研究北京市重点实验室北京市眼科学与视觉科学重点实验室;
【基金】：国家自然科学基金(No:81570891) 北京市自然科学基金(No:7151003) 北京市医院管理局“登峰”人才培养计划(No:DFL20150201);北京市医院管理局临床医学发展专项经费资助(扬帆计划)(No:ZYLX201307) 眼内肿瘤诊治研究北京市重点实验室2015年度科技创新基地培育与发展专项项目(No:Z151100001615052) 北京市卫生系统高层次卫生技术人才培养计划(No:2014-2-003)
【分类号】：R445.1;R739.7

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