葡萄膜转移癌的超声诊断特征分析  

Ultrasound diagnosis and analysis of uveal metastatic carcinoma

作　　者：王子杨[1] 杨文利[1] 李栋军[1] 陈伟[1] 赵琦[1] 李逸丰[1] 崔蕊[1] 沈琳[1] 魏文斌[1] 

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内肿瘤诊治研究北京市重点实验室北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《肿瘤影像学》2016年第4期-,共6页Oncoradiology

基　　金：国家自然科学基金(No:81570891);北京市自然科学基金(No:7151003);北京市医院管理局"登峰"人才培养计划(No:DFL20150201);北京市医院管理局临床医学发展专项经费资助(扬帆计划)(No:ZYLX201307);眼内肿瘤诊治研究北京市重点实验室2015年度科技创新基地培育与发展专项项目(No:Z151100001615052);北京市卫生系统高层次卫生技术人才培养计划(No:2014-2-003)

摘　　要：目的:探讨葡萄膜转移癌的超声诊断特征。方法:回顾性分析2012年1月—2016年11月北京同仁医院眼科收治的葡萄膜转移癌患者25例(29只眼),分析超声检查中病变的位置、形态、隆起高度、基底-高度比率、内回声及其特点、有无挖空征和脉络膜凹陷征、有无继发视网膜脱离和玻璃体混浊、彩色多普勒血流成像(color Doppler flow imaging,CDFI)检查病变内血流情况等。其中14例(14只眼)行超声造影检查,并进行时间-强度曲线分析。结果:25例(29只眼)葡萄膜转移癌患者,累及左眼8例(32.0%)、右眼13例(52.0%)、双眼4例(16.0%);位于虹膜睫状体4只眼(13.8%)、脉络膜25只眼(86.2%);7只眼(24.1%)病变超声表现为扁平隆起回声、7只眼(24.1%)为半球形隆起回声、15只眼(51.7%)病变表面回声不规则(可见切迹或呈波浪状);病变隆起高度平均为(3.5±2.2)mm,基底-高度比率平均为3.7±2.1;27只眼(93.1%)病变内回声表现为低于相邻眶内组织的低回声;2只眼(6.9%)挖空征阳性,5只眼(17.2%)脉络膜凹陷征阳性;21只眼(72.4%)出现继发视网膜脱离,11只眼(38.0%)合并玻璃体混浊。CDFI检查显示,21只眼(72.4%)病变内可见树枝状血流信号。14例(14只眼)行超声造影检查,其中13只眼(92.9%)病变的时间-强度曲线表现为快进快出型。结论:葡萄转移癌超声检查有一定的特征性表现,可为临床提供可靠的诊断和鉴别诊断依据。Objective:To investigate the ultrasonographic characteristics of uveal metastatic carcinoma.Methods:The data of 29 eyes of 25 patients diagnosed of uveal metastatic carcinoma from January 2012 to November 2016 were retrospectively analyzed. The B-mode ultrasonography and color Doppler flow imaging (CDFI) were performed on them. Contrast-enhanced ultrasound was performed on 14 cases (14 eyes), and the characteristics of the time-intensity curve of the contrast agent were analyzed.Results:Among 25 cases (29 eyes) of uveal metastatic carcinoma, left eye was involved in 8 cases (32.0%), right eye was involved in 13 cases (52.0%) and both eyes were involved in 4 cases (16.0%). Four eyes (13.8%) located in the iris ciliary body and 25 eyes (86.2%) in the choroid. Ultrasound showed lfat echo lesion in 7 eyes (24.1%), hemispherical echo in 7 eyes (24.1%), and irregular surface of notch or wavy in 15 eyes (51.7%). The mean height of the lesions was (3.5±2.2) mm, and the mean base-height ratio was 3.7±2.1. In 27 eyes (93.1%) the echo of the lesions was lower than that of the adjacent orbital tissues. Two eyes (6.9%) showed hollowing out, and 5 eyes (17.2%) showed choroidal excavation. Secondary retinal detachment occurred in 21 eyes (72.4%), and vitreous opacity in 11 eyes (38.0%). CDFI examination showed branch-shaped blood lfow signal in 21 eyes (72.4%). The time-intensity curve in 13 eyes (92.9%) showed “quick in and quick out”.Conclusion:Uveal metastatic carcinoma has certain ultrasonographic characteristics, which can provide a reliable basis for clinical diagnosis and differential diagnosis.

关 键 词：葡萄膜转移癌 彩色多普勒超声 造影剂 

分 类 号：R445.1[医药卫生—影像医学与核医学]