半球形与扁平形葡萄膜转移瘤MRI征象对比研究  

Comparative research on MR imaging features of dome-shaped and plat-shaped uveal metastases

作　　者：陈青华[1,2] 孙明霞[1,3] 顼晓琳 张宗锐[1,2] 李彬[2,4] 燕飞 魏文斌[2,5] 鲜军舫[1,2,6] CHEN Qinghua;SUN Mingxia;XU Xiaolin;ZHANG Zongrui;LI Bin;YAN Fei;WEI Wenbin;XIAN Junfang(Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, P.R.China;Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, P.R.China;Department of Radiology, Shunyi District Hospital, Beijing 101300, P.R.China;Beijing Ophthalmology Institute, Beijing 100730, P.R.China;Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, P.R.China;Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing 100730, P.R.China)

机构地区：[1]首都医科大学附属北京同仁医院放射科,北京100730 [2]首都医科大学眼部肿瘤临床诊疗与研究中心,北京100730 [3]北京市顺义区医院放射科,北京101300 [4]北京市眼科研究所,北京100730 [5]首都医科大学附属北京同仁医院眼科,北京100730 [6]首都医科大学眼内肿瘤诊治研究北京市重点实验室,北京100730

出　　处：《医学影像学杂志》2019年第8期1274-1278,共5页Journal of Medical Imaging

基　　金：北京市医院管理局临床医学发展专项经费资助(“扬帆”计划眼耳鼻喉影像重点医学专业)(编号:ZYLX201704);北京市卫生系统高层次卫生技术人才培养计划项目(编号:2014-2-005);首都医科大学眼内肿瘤诊治研究北京市重点实验室开放研究课题资助项目(编号:2016YNZL03)

摘　　要：目的 对比分析半球形与扁平形葡萄膜转移癌的MRI征象,探讨MRI对不同形态葡萄膜转移癌的诊断价值。方法 回顾性收集北京同仁医院2005~2015年经手术病理或临床综合诊断确诊的眼葡萄膜转移癌49例,平均年龄(52.5±12.3)岁,其中男性19例,女性30例,左眼26例,右眼21例,双眼2例,根据病变形态分为扁平形组(36例)和半球形组(13例)。比较两组临床表现及MRI征象,包括患者年龄、性别、肿块侧别、部位、形态、边缘、是否伴发视网膜脱离、T1WI和T2WI信号(与脑灰质相比)、T1WI和T2WI信号均匀度、强化程度、强化均匀度、强化指数、肿块高度、基底径、基底径与高度比值,计数资料采用Pearson卡方检验,计量资料采用独立样本秩和检验。结果 肿块T1WI信号均匀度、增强程度、强化指数在两组间均有显著差异﹙x^2=4.491、5.026、5.914,P=0.034、0.025、0.015),患者性别、侧别、肿块部位、形态、边缘、是否伴发视网膜脱离、T1WI和T2WI信号(与脑灰质相比)、T2WI信号均匀度均无显著性差异(P>0.05),基底径与高度比值在扁平形组(0.8~11.3mm,中位数2.9mm)和半球形组(1.0~6.0mm,中位数2.0mm)两组间均有显著差异(Z=-1.998,P=0.046),患者年龄、肿块高度、基底径均无显著性差异(P>0.05)。结论 半球形与扁平形葡萄膜转移癌的MRI征象存在一定差异,半球形葡萄膜转移癌仍具备多数葡萄膜转移癌T1WI、T2WI多呈等信号的特点,MRI对葡萄膜转移癌具有重要价值。Objective To compare the MRI signs of dome-shaped and plat-shaped uveal metastases, and to evaluate the diagnostic value of MRI for different forms of uveal metastases. Methods A retrospective study was carried out on MR imaging findings of 49 patients with uveal metastases confirmed by histopathologic results or clinical comprehensive diagnosis from 2005 to 2015 in Beijing Tongren hospital, age (52.5±12.3) years old, including 19 males, 30 females, 26 left eyes, 21 right eyes, 2 bilateral eyes. According to lesion morphology, the cases were divided into a flat-shaped group (36 cases) and a dome-shaped group (13 cases). The clinical manifestations and MRI signs of the uveal metastases were compared between the two groups, including patient age, gender, location, morphology, margin, retinal detachment, T 1WI and T 2WI signals (compared to gray matter), T 1WI and T 2WI signal uniformity, degree of enhancement, homogeneity, contrast index, height of the mass, the diameter of the base, and the ratio of the base and the height were assessed. The Pearson chi-square test was used for the counting data, and the independent sample rank test was used for the measurement data. Results The signal homogeneity in T 1WI, degree of en-hancement and contrast index were significantly different between the flat-shaped group and the dome-shaped group of the uveal metastases ﹙ x^2=4.491, 5.026, 5.914, P =0.034, 0.025, 0.015). There were no significant differences in patient gender, side, mass location, morphology, margin, retinal detachment, signal intensity on T 1- and T 2WI (compared to gray matter), signal homogeneity on T 2WI( P >0.05). The ratio of base diameter to height was significantly different between the flat group (from 0.8 mm to 11.3 mm, median 2.9 mm) and the dome group (from 1.0 mm to 6.0 mm, median 2.0 mm)( Z =- 1.998, P =0.046). There were no significant differences in patient age, height of the tumor, and basal diameter ( P >0.05). Conclusion The MR signs of dome-shaped and flat- shaped uveal metastases are sign

关 键 词：葡萄膜肿瘤 转移瘤 磁共振成像 

分 类 号：R773[医药卫生—眼科] R445.2[医药卫生—临床医学]