葡萄膜黑色素瘤高频彩超的诊断和鉴别诊断
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Diagnosis and differentiation of uveal melanoma with high-frequency color doppler ultrasound
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    目的:探讨彩色多普勒血流显像(color doppler flow imaging,CDFI)在葡萄膜黑色素瘤的诊断和鉴别诊断中的临床价值。方法:应用高频彩色多普勒超声仪检查葡萄膜黑色素瘤患者33例,均经病理证实。其他眼内肿物患者56例,经病理或随访证实。对所有病例的临床资料和超声诊断数据进行回顾性分析。结果:脉络膜黑色素瘤32例,睫状体黑色素瘤1例。瘤体呈中低回声,边界清楚整齐。其中有18例形成具有特征性的“挖空现象”, 15例表现为“脉络膜凹陷” 。外形表现为“圆顶样”28例,“蘑菇样”5例。CDFI显示病灶内有丰富的动脉血流25例,单支少量血流有6例,均来自睫后短动脉。所有病例均有不同程度的视网膜脱离。其他眼内肿物患者包括6例睫状体肿块,葡萄膜转移癌8例,脉络膜血肿16例,脉络膜血管瘤8例,视网膜母细胞瘤18例。结论:高频彩超对葡萄膜黑色素瘤的诊断及与其他眼内肿块鉴别诊断有重要价值。

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    Objective:To evaluate the diagnosis of melanoma of uvea with color doppler ultrasound and differential diagnosis with other intraocular mass. Methods:Sonogram of 33 patients with melanoma of uvea and 56 patients with other intraocular mass were retrospective analyzed. All diagnosis were confirmed by pathology or following up. Results:Thirty-two patients of uveal melanoma included 32 cases of choroidal melanoma and 1 case of ciliary body melanoma. From them,lesions of 28 patients were hemicycle in shape. The other masses were in mushroom shape. All 32 melanomas of uvea appeared isoechoic or hypoechoic,well-defined boundary lesions in ultrasound. In those,18 tumors were of anterior hyper-echogenicity and posterior attenuation which called scooping phenomenon and 15 tumors had choroidal excavation. Vigorous flow in 25 lesions and manipulus flow in the other 6 lesions from short posterior ciliary arteries could be detected with color doppler flow imaging. All patients had retinal detachment in different level. Other intraocular masses included 6 cases of ciliary body tumors,8 cases were uveal metastatic carcinoma,16 cases were choroidal hematoma,8 cases were choroidal hemangioma and 18 cases were retinoblastoma. Conclusion:High frequency color doppler ultrasonography has great value in the diagnosis and differential diagnosis of uveal melanoma.

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王亚丽,胡建群,敬 雷.葡萄膜黑色素瘤高频彩超的诊断和鉴别诊断[J].南京医科大学学报(自然科学版),2013,(2):243-246

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  • 收稿日期:2012-08-08
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  • 在线发布日期: 2013-03-05
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