早期非典型性视网膜星形细胞错构瘤的多模式影像学特征  

Multimodal imaging characteristics of early atypical retinal astrocytic hamartoma

作　　者：刘志强 吕丽娜 张胜娟 肖哲 兴辰 LIU Zhiqiang;L Lina;ZHANG Shengjuan;XIAO Zhe;XING Chen(Hebei Eye Hospital,Xingtai 054001,Hebei Province,China)

机构地区：[1]河北省眼科医院,河北省邢台市054001

出　　处：《眼科新进展》2021年第8期779-782,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨早期非典型性视网膜星形细胞错构瘤影像学特征。方法收集2019年3月至2020年10月就诊于河北省眼科医院临床诊断为早期非典型性视网膜星形细胞错构瘤的患者8例8眼,对所有患者进行常规眼科检查以及彩色眼底照相、红外眼底照相、荧光素眼底血管造影(FFA)或吲哚菁绿血管造影(ICGA)、OCT、OCTA检查。同时给予患者药物治疗,在治疗期间密切检测眼底变化,病情稳定后继续观察3~6个月。观察患者不同时期的OCT、OCTA及FFA的特征性变化。对患者不同时期各项检查的临床特征进行汇总分析。结果所有患者头颅CT及皮肤检查均未发现异常。B超检查未见患者眼底肿物发生钙化;8例(8眼)早期非典型性视网膜星形细胞错构瘤均为单眼单个病灶;病变位置在盘周和后极部附近。彩色眼底照相及红外眼底照相显示,6眼患者瘤体为卵圆形结节状不规则扁平隆起,呈半透明状,可透见视网膜血管,2眼呈扁平隆起,周围无渗出及水肿。FFA检查结果显示,6眼患者瘤体表面毛细血管呈团状扩张,发出弱荧光,毛细血管位于视网膜血管之下;1眼患者后期FFA检查呈强荧光渗漏,1眼仅后期呈强荧光表现。ICGA检查结果显示,患者瘤体对应脉络膜血管未发现异常改变。OCT检查结果显示,所有患者病变区的视网膜内层均出现局限性不均匀增厚,结构紊乱,5眼为虫蚀状改变并伴有低反射区域;3眼仅表现为视网膜神经纤维层局限性增厚并伴有低反射区域。OCTA检查结果显示,8眼患者早期病灶内均可看到团状扩张血管,浅层毛细血管层瘤体表面可见大量的毛细血管网,深层毛细血管层瘤体内可见杂乱的血管影,呈不规则的低反射。利用OCTA追踪复查扫描患者瘤体同一位置,发现随着病情进一步好转,瘤体缩小,最后血管扩张逐渐减轻,恢复正常形态。结论采用多模式影像学检查有助于对早期非典型性视网膜�Objective To investigate the imaging characteristics of early atypical retinal astrocytic hamartoma(RAH).Methods Together 8 patients(8 eyes)who visited Hebei Eye Hospital during March 2019 to October 2020 with clinical diagnosis of early atypical RAH were included in this study.All patients underwent routine ophthalmic examinations,color fundus photography,infrared fundus photography,fundus fluorescein angiography(FFA),indocyanine green angiography(ICGA),optical coherence tomography(OCT),and optical coherence tomography angiography(OCTA)during and 3-6 months accompanied with drug therapy,the changes of OCT,OCTA and FFA in different periods were recorded.Then the clinical features of patients in different periods were summarized and analyzed.Results The head CT and skin examination results of all patients were normal,and no calcification was found in the fundus masses through B-ultrasonography.The lesion of all the 8 patients(8 eyes)with early atypical RAH occurred singly,located at the peripapillary region and posterior pole.Color fundus photography and infrared fundus photography showed that the tumors were oval,nodular,irregular,translucent and flat bulges in 6 eyes,and the retinal vessels were observed.The tumors were flat bulges in 2 eyes with no exudation or edema.FFA showed that the capillaries on the surface of tumor represented clustered dilation with weak fluorescence in 6 eyes,and the capillaries were located under the retinal vessels.The lesion of 1 eye showed strong fluorescence leakage in the late stage of FFA,while 1 eye showed strong fluorescence in the late stage of FFA with no leakage.ICGA were normal in the choroidal vessels corresponding to the tumor body.OCT showed inhomogeneous thickening and disorder of the inner retinal layer in all 8 eyes.The moth-eaten lesion with low reflex areas was demonstrated in 5 eyes.The other 3 eyes showed localized thickening of the retinal nerve fiber layer with low reflex areas.OCTA represented clump-like dilated blood vessels in the early lesions of all the 8

关 键 词：非典型性视网膜星形细胞错构瘤 荧光素眼底血管造影 吲哚菁绿血管造影 多模式影像学检查 

分 类 号：R774[医药卫生—眼科]