累及视神经的脉络膜转移癌临床及影像学特征  

Clinical and imaging characteristics of choroidal metastasis involving optic nerve

作　　者：李娟娟[1] 黎铧[1] 韦春玲[1] 张利伟[1] 

机构地区：[1]昆明医科大学第四附属医院眼科,云南省昆明市650021

出　　处：《眼科新进展》2012年第12期1154-1156,1160,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨累及视神经的脉络膜转移癌的临床特征及影像学特点。方法收集我院所诊治的侵犯视神经的脉络膜转移癌患者5例(5眼)的临床资料,分析其眼底表现、眼部B超、彩色超声多普勒、眼底荧光血管造影、MRI等影像学检查特征。结果 5眼均可见眼底后极部累及视神经及其周围脉络膜组织的扁平实质性占位病变,视盘隆起、水肿,表面小血管扩张,动脉期即出现荧光素渗漏。B超表现为视神经附近沿眼球壁扁平隆起的病灶,视盘隆起且回声增强。眼部彩色超声多普勒可见肿块内血流信号。眼部MRI:眼球后壁视盘区局限性增厚,T1WI呈高于玻璃体的中等信号,T2WI瘤体呈低信号,累及视神经球内段及眶内段起始部,视神经增粗。结论累及视神经的脉络膜转移癌诊断需结合详细的病史、综合的影像学检查,并重视与相关视神经疾病的鉴别诊断,该类患者的视力预后及生命预后均不佳。Objective To determine the clinical and imaging characteristics of choroidal metastasis involving optic nerve. Methods A total of 5 patients （ 5 eyes） with choroidal metastasis involving optic nerve in our hospital were chosen, and the clinical data and imaging characteristics of fundus fluorescent angiography,B-scan, col- or Doppler ultrasound, MRI and fundus imaging were retrospective analyzed. Results Optic metastasis showed a mass involving the disc, combined with optic edema and flame hemorrhage, fluorescent element leakage at the arterial stage appeared. B-scan showed a mild elevation of the optic disc and color Doppler ultrasound showed the blood signal within the mass. MRI showed T1W was higher than the vitreous medium signal,and T2W was low signal involving the optic nerve within the intraocular section and the initial orbital section, optic nerve increased thick. Conclusion The diagnosis of choroidal metastasis involving optic nerve should be combined with a detailed histo- ry, comprehensive imaging examinations, and pay attention to the differential diagnosis of related optic nerve disease, the eye sight prognosis and life prognosis of these pa- tients are poor.

关 键 词：脉络膜转移癌 视神经 彩色超声多普勒 MRI 

分 类 号：R739.7[医药卫生—肿瘤]