超声造影分析脉络膜转移癌与脉络膜血管瘤血流灌注特点  

Perfusion characteristics analysis of contrast-enhanced ultrasound in choroidal metastasis and choroidal hemangioma

作　　者：李栋军 杨文利 王子杨 陈伟 赵琦 李逸丰 崔蕊 沈琳 刘倩 刘月明 魏文斌 Li Dongjun;Yang Wenli;Wang Ziyang;Chen Wei;Zhao Qi;Li Yifeng;Cui Rui;Shen Lin;Liu Qian;Liu Yueming;Wei Wenbin(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Ophthalmology and Visual Sciences Key Laboratory,Capital Medical University,Beijing 100730,China)

机构地区：[1]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：《中华超声影像学杂志》2021年第7期563-568,共6页Chinese Journal of Ultrasonography

基　　金：国家重点研发计划资助(2018YFC0116000);首都卫生发展科研专项(首发2020-1-2052);北京市科委科技计划项目(Z181100001818003);北京市医院管理局"登峰"人才培养计划(DFL20150201)。

摘　　要：目的通过超声造影分析脉络膜转移癌的血流灌注特点以及与脉络膜血管瘤的血流灌注差异。方法本研究为回顾性研究。选取2016年1月至2018年2月于北京同仁医院眼科中心确诊的脉络膜转移癌患者21例(21只眼)作为脉络膜转移癌组,纳入同时期确诊的脉络膜血管瘤患者46例(46只眼)作为脉络膜血管瘤组。患者均行超声造影检查,获得肿瘤及其相邻正常眶内组织的超声造影定量参数:峰值强度(maximum of intensity,IMAX)、上升时间(rise time,RT)、达峰时间(time to peak,TTP)、平均渡越时间(mean transit time,mTT),比较脉络膜转移癌与其相邻眶内正常组织定量参数的差异以及脉络膜转移癌与脉络膜血管瘤定量参数的差异。采用ROC曲线分析定量参数鉴别脉络膜转移癌和脉络膜血管瘤的效能。结果脉络膜转移癌的IMAX大于眶内正常组织,RT、TTP、mTT小于眶内正常组织,差异有统计学意义(均P<0.01);脉络膜转移癌组IMAX小于脉络膜血管瘤组,RT、TTP、mTT小于脉络膜血管瘤组,差异有统计学意义(均P<0.01)。ROC曲线分析显示,超声造影定量参数IMAX、RT、TTP及mTT鉴别两种肿瘤的曲线下面积分别为0.775(95%CI=0.666~0.884)、0.970(95%CI=0.896~0.996)、0.729(95%CI=0.607~0.831)、0.992(95%CI=0.931~1.000),敏感性分别为71.7%、95.7%、76.1%、95.7%,特异性分别为85.7%、90.5%、66.7%、95.2%。结论超声造影可以显示脉络膜转移癌与脉络膜血管瘤的血流灌注差异,超声造影定量参数RT及mTT在两种肿瘤的鉴别诊断中有一定的价值。Objective To analyze the perfusion characteristics of choroidal metastasis using contrast-enhanced ultrasound,and compare with choroidal hemangioma.Methods This was a retrospective study.From January 2016 to February 2018 in Beijing Tongren Hospital,a total of 21 eyes from 21 patients who were clinically diagnosed as choroidal metastasis were included as the choroidal metastasis group and 46 eyes from 46 patients who were diagnosed as choroidal hemangioma during the same period were included as the choroidal hemangioma group.All patients underwent contrast-enhanced ultrasound examination,and Sonoliver was used to obtain the data on quantitative parameters of the tumor and the adjacent normal orbital tissues,including maximum of intensity(IMAX),rise time(RT),time to peak(TTP),and mean transit time(mTT).The quantitative parameters between choroidal metastasis and normal orbital tissues were compared.And the quantitative parameters between choroidal metastasis and choroidal hemangioma were compared.The receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic performance.Results The IMAX of choroidal metastasis was significantly higher than that of normal orbital tissues,while RT,TTP and mTT were significantly shorter than these of normal orbital tissues(all P<0.01).The IMAX of choroidal metastasis was lower than that of choroidal hemangioma,and RT,TTP and mTT were shorter than choroidal hemangioma(all P<0.01).The ROC curve analysis showed that area under curves of the IMAX,RT,TTP and mTT were 0.775(95%CI=0.666-0.884),0.970(95%CI=0.896-0.996),0.729(95%CI=0.607-0.831)and 0.992(95%CI=0.931-1.000)respectively.The sensitivities were 71.7%,95.7%,76.1%and 95.7%,and the specificities were 85.7%,90.5%,66.7%and 95.2%,respectively.Conclusions Contrast-enhanced ultrasound can reflect the differences in perfusion characteristics between choroidal metastasis and choroidal hemangioma.RT and mTT are useful parameters in differential diagnosis between the two types of tumors.

关 键 词：超声造影 脉络膜转移癌 脉络膜血管瘤 

分 类 号：R739.7[医药卫生—肿瘤]