超声诊断在成人脉络膜恶性肿瘤中的应用  

Application of Ultrasound Diagnosis in Adults with Choroidal Malignancies

作　　者：王克朕 任明玉 张蕾[3] 程彦彦 王健杰 尹会苏 路璐 WANG Kezhen;REN Mingyu;ZHANG Lei;CHEN Yanyan;WANG Jianjie;YIN Huisu;LU Lu(Tianjin Jinnan Hospital,Tianjin 300052,China;Hebei Eye Hospital,Hebei 054000,China;Tianjin Eye Hospital,Tianjin 300020,China;Graduate School,Hebei Medical University,Hebei 050017,China)

机构地区：[1]天津市津南医院,天津300052 [2]河北省眼科医院,河北054000 [3]天津市眼科医院,天津300020 [4]河北医科大学研究生学院,河北050017

出　　处：《影像科学与光化学》2025年第2期66-72,共7页Imaging Science and Photochemistry

基　　金：河北省邢台市重点研发计划项目(2022ZC228)。

摘　　要：目的:评估超声检查在成人脉络膜恶性肿瘤诊断中的应用价值。方法:本文采取回顾性研究,综合研究24例经病理确诊的脉络膜恶性肿瘤患者的临床资料。分析超声检查特征与病理诊断的一致性,以及其在脉络膜恶性肿瘤诊断和鉴别诊断中的意义。结果:在24例患者中,肿物颜色经眼底检查判定为棕黑色或棕灰色的有13例(54.17%),黄白色4例(16.67%),暗红色2例(8.33%),由于出血或视网膜脱离导致颜色无法辨认的有5例(20.83%)。超声检查肿物形状呈多样性,其中蕈伞状2例,哑铃形5例,类球形3例,半球形7例,扁平形5例,不规则形2例。其中前四项占70.83%,均为脉络膜黑色素瘤。而转移癌均呈扁平形状。另外显示14例(58.33%)有明显的挖空征,所有患者均显示不同程度的脉络膜压迹。彩色多普勒超声检查发现6例(25%)肿瘤内部有点状血流信号,而18例(75%)肿瘤内部观察到丰富血流信号。结论:超声检查显示的肿物形状特点及挖空征、脉络膜压迹,特别是超声多普勒检查发现的肿瘤内部血流信号是成人脉络膜恶性肿瘤的典型特征,可作为诊断和鉴别诊断脉络膜恶性肿瘤的首选可靠方法和诊断依据,尤其是在区分出血与实体性肿瘤方面具有重要临床应用价值。Objective:To evaluate the value of ultrasonography in diagnosing adult choroidal malignancies.Methods:The clinical data of 24 patients with malignant choroidal tumors diagnosed by pathology were studied retrospectively,and the consistency of ultrasonic characteristics and pathological diagnosis was analyzed.Furthermore,the significance of ultrasound examination in the diagnosis and differential diagnosis of choroidal malignancies.Results:Among the 24 patients,13 cases(54.17%),4 cases(16.67%)were yellowish⁃white,2 cases(8.33%)were dark red,and 5 cases(20.83%)were unrecognizable due to hemorrhage or retinal detachment.In the ultrasonographic examination of these 24 patients,the shapes of the masses were diverse,including 2 mushroomshaped cases,5 dumbbell⁃shaped cases,3 spheroid cases,7 hemispherical cases,5 flat⁃shaped cases,and 2 irregular⁃shaped cases.Ultrasonography showed that 14 cases(58.33%)had obvious excavation signs,and all patients showed choroidal indentation of varying degrees.Doppler⁃ultrasonography showed spotty blood flow signals in 6 cases(25%)and rich blood flow signals in 18 cases(75%).Conclusion:The shape characteristics and the excavation sign and choroidal indentation of the tumor displayed by ultrasonic examination,especially the blood flow signals inside the tumor discovered by ultrasound Doppler examination,are typical features of adult choroidal malignancies and can be used as the preferred reliable method and diagnostic basis for diagnosis and differential diagnosis of choroidal malignancies,especially in distinguishing bleeding from solid tumors,which has important clinical application value.

关 键 词：恶性肿瘤 脉络膜 超声诊断 成人 

分 类 号：R445.1[医药卫生—影像医学与核医学]