13例误诊为黑色素瘤的脉络膜病变MRI分析  

MRI Characteristics of Choroidal Lesions Misdiagnosed as Melanoma in 13 Cases

作　　者：王小蓉[1] 徐飞荣 谢筱筱[1] 姚庆东[1] 王营营[1] 许崇永[1] 宋樟伟[1] 程小杰[1] 

机构地区：[1]温州医学院附属第二医院,育英儿童医院放射科,325027 [2]宁波妇女儿童医院放射科,315012

出　　处：《医学研究杂志》2013年第1期159-162,共4页Journal of Medical Research

摘　　要：目的分析13例误诊为黑色素瘤的脉络膜病变的MRI表现,以提高对本病的认识。方法回顾性分析2007年1月～2011年12月在温州医学院附属医院13例误诊为黑色素瘤的脉络膜病变的临床及影像学资料,11例经手术或活检病理证实,2例骨瘤经影像学、临床及随访证实。结果 13例中,转移瘤2例,脉络膜血管瘤2例,脉络膜骨瘤2例,脉络膜睫状体神经鞘瘤1例,视网膜或脉络膜下出血6例;病灶位于眼球后壁12例,睫状体脉络膜处1例;边缘整齐6例,不整齐7例;13例行MRI检查,CT平扫1例,转移瘤、血管瘤及神经鞘瘤T1WI呈等、稍高信号,T2WI呈等、低信号,骨瘤T1WI呈等、低信号,T2WI均呈等信号,在CT表现为弧形高密度,视网膜或脉络膜下出血T1WI呈等、高信号,T2WI呈等、低信号;本组5例增强,均明显强化。9例行彩色多普勒超声检查,2例误诊,2例未定性,5例正确诊断。结论脉络膜病变MRI T1WI信号较T2WI高或相等时,与脉络膜黑色素瘤鉴别困难,诊断时需结合临床及其他影像学资料。Objective To evaluate MRI characteristics of choroidal lesions misdiagnosed as melanoma in 13 cases, and to deepen the understanding of it. Methods The clinical and radiological data of 13 cases choroidal lesions misdiagnoscd as melanoma in affiliated hospitals of Wenzhou medical college from January 2007 to December 2011 were included in the study. 11 cases were confirmed by surgical or biopsy pathology, 2 cases of osteoma were confirmed by imaging or clinic follow - up. The imaging characteristics were retrospectively analyzed. Results Among 13 cases, there were choroidal metastatic carcinoma（ n = 2） , choroidal hemangioma （n = 2） , choroidal osteoma（ n = 2） , choroidal ciliary body schwannoma （ n = 1 ） and retinal or choroidal hemorrhage （n = 6）. 12 cases located in the posterior wall of eyeball and 1 case in ciliary body. 6 cases had well -defined marges, 7 cases had not. 13 cases did MRI examination,while 1 case did CT, metastasis, hemangioma and schwannma demonstrated iso -intensity or slight high signal intensity on T1 WI and iso -intensity or low signal intensity on T2WI, Osteoma demonstrated iso - intensity or low signal intensity on T1WI and iso - intensity on T2WI, high density in CT images. Retinal or choroidal hemorrhage demonstrated iso - intensity or high signal intensity on T1WI and iso - intensi- ty or low signal intensity on T2WI. The lesions enhanced obviously in 5 cases with Gd - DTPA enhancement scan. 9 cases did ultrasonic examination ,2 cases were misdiagnosed ,2 cases did not have sure result and 5 cases were diagnosed correctly. Conclusion When MRI T1 WI signal of choroidal lesions is higher or equivalent to T2WI, clinical and other imaging data should be comprehensively considered if you want to differentiate it from choroidal melanoma.

关 键 词：黑色素瘤 脉络膜病变 误诊 MRI 

分 类 号：R739.7[医药卫生—肿瘤]