葡萄膜黑色素瘤患者超声造影动态血管模型的参数变化  

Parameter changes of dynamic vascular patterns of contrast-enhanced ultrasound in uveal melanoma patients

作　　者：李栋军 杨文利 杨军[1] LI Dong-jun1,2, YANG Wen-li2, YANG Jun1(1. Institute of Biomedical Engineering, Chinese Academy of Medical Sciences ＆Peking Union Medical College, Tianjin 300192, China, MEDA Co. Ltd, Tianjin 300384, China ; 2. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, Chin)

机构地区：[1]北京协和医学院中国医学科学院生物医学工程研究所,天津300192 [2]首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730

出　　处：《眼科》2018年第2期103-106,共4页Ophthalmology in China

基　　金：中国医学科学院医学与健康科技创新工程协同创新团队项目(2017-I2M-3-020)

摘　　要：目的探讨动态血管模型(DVP)曲线及参数图在葡萄膜黑色素瘤超声造影诊断中的应用价值。设计实验研究。研究对象 53例(53眼)葡萄膜黑色素瘤患者的超声造影资料。方法通过Sonoliver软件对超声造影资料进行定量分析,并以病变与同一患者邻近正常眶内对照组织的增强水平差值构建DVP曲线及DVP参数图。根据病变绿色曲线开口方向与黄线的关系将DVP曲线分为Ⅰ~Ⅳ型,根据三组颜色是否出现将DVP参数图分为Ⅰ~Ⅳ型。主要指标峰值强度(IMAX)、上升时间(RT)、达峰时间(TTP)、平均渡越时间(m TT);DVP曲线及参数图类型的构成比。结果葡萄膜黑色素瘤的IMAX(210.08±102.14)%高于正常眶内对照组织(100.00±0.00)%(t=7.846,P=0.000)、葡萄膜黑色素瘤的m TT(39.40±17.97)s快于正常眶内对照组织(49.95±18.64)s(t=-3.417,P=0.001)。葡萄膜黑色素瘤DVP曲线:Ⅰ型38例(71.70%),Ⅱ型10例(18.87%),Ⅲ型3例(5.66%),Ⅳ型2例(3.77%)。DVP参数图:Ⅰ型43例(81.13%),Ⅱ型5例(9.43%),Ⅲ型3例(5.66%),Ⅳ型2例(3.77%)。结论超声造影DVP可以反映葡萄膜黑色素瘤与正常眶内组织之间的灌注差异特点,大多数葡萄膜黑色素瘤主要表现为Ⅰ型DVP曲线及Ⅰ型DVP参数图。Objective To study the application of dynamic vascular patterns（ DVP） curves and parametric images of contrast-enhanced ultrasound（ CEUS） in uveal melanoma. Design Experimental research. Participants 53 uveal melanoma patients（ 53 eyes） with CEUS examination. Methods Sonoliver software was used to analyze the CEUS images and construct the DVP curves and DVP parametric images according to the difference between the lesion and the normal control tissue of the same patient. According to the opening direction of the lesion＇s green curve and the relationship with the yellow line,the DVP curves were divided into Ⅰ ～ Ⅳ type; according to different color composition,the DVP parametric images were divided into Ⅰ ～ Ⅳ type. Main Outcome Measures Maximum of intensity（ IMAX）,rise time（ RT）,time to peak（ TTP）,mean transit time（ mTT）; The proportion of DVP curves and parameter diagrams type. Results The IMAX（ 210. 08 ± 102. 14） % was higher than that in normal orbital tissue（ 100. 00 ± 0. 00） %（ t = 7. 846,P = 0. 000）. The m TT（ 39. 40 ± 17. 97） s was faster than that in normal orbital tissue（ 49. 95 ±18. 64） s（ t =-3. 417,P = 0. 001）. The four types of DVP curves（ Ⅰ,Ⅱ,Ⅲ,Ⅳ） and DVP parametric images（ Ⅰ,Ⅱ,Ⅲ,Ⅳ） were 71. 70%,18. 87%,5. 66%,3. 77% and 81. 13%,9. 43%,5. 66%,3. 77% respectively. Conclusions Dynamic vascular patterns of contrast-enhanced ultrasound can demonstrate the different characteristics of flow perfusion static between uveal melanoma and normal orbital tissue.Most of the uveal melanomas show type I DVP curves and type Ⅰ DVP parametric images.

关 键 词：超声造影 动态血管模型 葡萄膜黑色素瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.7[医药卫生—诊断学]