视网膜色素上皮腺瘤的超声影像特征分析  

Ultrasonographic features of retinal pigment epithelial adenoma

作　　者：李逸丰 杨文利 魏文斌 杨丽红 顼晓琳 张旭 王倩 王爽 李栋军 王子杨 陈伟 赵琦 崔蕊 沈琳 刘倩 Li Yifeng;Yang Wenli;Wei Wenbin;Yang Lihong;Xu Xiaolin;Zhang Xu;Wang Qian;Wang Shuang;Li Dongjun;Wang Ziyang;Chen Wei;Zhao Qi;Cui Rui;Shen Lin;Liu Qian(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology&Visual Sciences,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、北京市眼科研究所、北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《中华眼科杂志》2023年第3期181-186,共6页Chinese Journal of Ophthalmology

基　　金：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(Z201100005520045,Z181100001818003)。

摘　　要：目的探讨视网膜色素上皮(RPE)腺瘤的超声影像特征。方法回顾性病例系列研究。收集2013年11月至2019年10月首都医科大学附属北京同仁医院收治且眼内肿瘤局部切除手术后经组织病理学检查证实为RPE腺瘤15例(15只眼)患者的临床资料,分析患者的一般情况及眼部超声影像图中肿瘤的位置、大小、形态、内部回声以及彩色多普勒血流图(CDFI)检查的肿瘤内血流情况。结果15例患者中,男性7例、女性8例;年龄(45.7±10.2)岁,范围25~58岁。出现最多的症状是视力下降或视物模糊(11例),其他包括眼前黑影或遮挡感(3例)和无症状(1例);1例患者存在既往眼部外伤史,其余患者均没有明确眼部外伤史。RPE腺瘤生长部位分散。超声检查示肿瘤最大基底径(8.07±2.75)mm,高度(4.02±1.81)mm;形态多为陡峭隆起的圆顶形(6例),边缘不光滑,内部呈中或低回声,其中2例肿瘤内部可见挖空征;无脉络膜凹陷;可继发视网膜脱离及玻璃体混浊;CDFI检查示肿瘤内可见血流信号。结论RPE腺瘤的超声影像特征是多为陡峭隆起的圆顶形态、边缘不光滑、无脉络膜凹陷,可为临床诊断及鉴别诊断提供参考。Objective To investigate the ultrasonographic features of retinal pigment epithelium(RPE)adenoma.Methods It was a retrospective case series study.The clinical clata of 15 patients(15 eyes)with pathologically confirmed RPE adenoma after local resection of intraocular tumor was collected at Beijing Tongren Hospital,Capital Medical University from November 2013 to October 2019.The general conditions of the patients and the location,size,shape,internal echo features of the lesions in the ocular ultrasound sonogram were analyzed,and the blood flow in the lesions was checked by color Doppler flow imaging(CDFI).Results Of all the patients included in the study,7 were male and 8 were female.Their age ranged from 25 to 58 years,with a mean age of(45.7±10.2)years.The most common symptom was vision loss or blurred vision(11 cases).Other symptoms included dark shadows or obscuration in front of the eyes(3 cases)and no symptoms(1 case).A history of previous ocular trauma was present in one case,and the rest of the patients had no history of ocular trauma.The location of tumor growth is scattered.The ultrasonographic features were as follows:the average maximum basal diameter was(8.07±2.75)mm and the average height was(4.02±1.81)mm;the ultrasonographic features mostly demonstrated abruptly elevated dome-shaped echo(6 cases);the lesion edge was not smooth,the internal echo was medium or low,and there could be hollow features(2 cases),with no choroidal depression;and the blood flow signal could be seen in the CDFI lesion,which could lead to retinal detachment and vitreous opacification.Conclusion The ultrasound imaging features of RPE adenomas mostly demonstrate abruptly elevated dome-shaped echo,unsmooth lesion edge,with no choroidal depression,which may provide valuable evidence for clinical diagnosis and differentiation.

关 键 词：视网膜肿瘤 视网膜色素上皮 腺瘤 超声检查 多普勒 彩色 

分 类 号：R739.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]