本文選題：葡萄膜轉(zhuǎn)移癌 + 彩色多普勒超聲��； 參考：《腫瘤影像學(xué)》2016年04期

【摘要】：目的:探討葡萄膜轉(zhuǎn)移癌的超聲診斷特征。方法:回顧性分析2012年1月—2016年11月北京同仁醫(yī)院眼科收治的葡萄膜轉(zhuǎn)移癌患者25例(29只眼),分析超聲檢查中病變的位置、形態(tài)、隆起高度、基底-高度比率、內(nèi)回聲及其特點(diǎn)、有無(wú)挖空征和脈絡(luò)膜凹陷征、有無(wú)繼發(fā)視網(wǎng)膜脫離和玻璃體混濁、彩色多普勒血流成像(color Doppler flow imaging,CDFI)檢查病變內(nèi)血流情況等。其中14例(14只眼)行超聲造影檢查,并進(jìn)行時(shí)間-強(qiáng)度曲線分析。結(jié)果:25例(29只眼)葡萄膜轉(zhuǎn)移癌患者,累及左眼8例(32.0%)、右眼13例(52.0%)、雙眼4例(16.0%);位于虹膜睫狀體4只眼(13.8%)、脈絡(luò)膜25只眼(86.2%);7只眼(24.1%)病變超聲表現(xiàn)為扁平隆起回聲、7只眼(24.1%)為半球形隆起回聲、15只眼(51.7%)病變表面回聲不規(guī)則(可見(jiàn)切跡或呈波浪狀);病變隆起高度平均為(3.5±2.2)mm,基底-高度比率平均為3.7±2.1;27只眼(93.1%)病變內(nèi)回聲表現(xiàn)為低于相鄰眶內(nèi)組織的低回聲;2只眼(6.9%)挖空征陽(yáng)性,5只眼(17.2%)脈絡(luò)膜凹陷征陽(yáng)性;21只眼(72.4%)出現(xiàn)繼發(fā)視網(wǎng)膜脫離,11只眼(38.0%)合并玻璃體混濁。CDFI檢查顯示,21只眼(72.4%)病變內(nèi)可見(jiàn)樹(shù)枝狀血流信號(hào)。14例(14只眼)行超聲造影檢查,其中13只眼(92.9%)病變的時(shí)間-強(qiáng)度曲線表現(xiàn)為快進(jìn)快出型。結(jié)論:葡萄轉(zhuǎn)移癌超聲檢查有一定的特征性表現(xiàn),可為臨床提供可靠的診斷和鑒別診斷依據(jù)。
[Abstract]:Objective: to investigate the characteristics of ultrasonic diagnosis of uveal metastatic carcinoma. Methods: Twenty-five patients (29 eyes) with metastatic uveal carcinoma admitted to Tongren Hospital from January 2012 to November 2016 were analyzed retrospectively. The location, shape, height of protuberance, ratio of basal to height in ultrasound examination were analyzed. The internal echo and its characteristics, whether there are hollowness sign, choroidal depression sign, secondary retinal detachment and vitreous opacity, color Doppler flow imaging and CDFI are used to examine the blood flow in the lesions. Among them, 14 cases (14 eyes) were examined by contrast-enhanced ultrasonography, and time-intensity curves were analyzed. Results 25 cases (29 eyes) with metastatic carcinoma of the uveal membrane, 8 cases (32.0%) were involved in left eye, 13 cases (52.0%) in right eye, 4 cases (16.0%) in binocular, 4 eyes (13.8%) were located in iris and ciliary body, 7 eyes (24.1%) were located in iris ciliary body, 7 eyes (24.1%) were located in choroid body, 7 eyes (24.1%) showed flattened protuberance echo, 15 eyes (51.7%) were surface lesion of hemispherical eminence echo. The mean height of the lesion was (3.5 鹵2.2) mm and the ratio of basal to height was 3.7 鹵2.1% (93.1%) in 27 eyes (93. 1%), which was lower than that in 2 eyes (6. 9%) with low echo in adjacent orbital tissues. In 5 eyes (17.2%), 21 eyes (72.4%) had secondary retinal detachment, 11 eyes (38.0%) had secondary retinal detachment and vitreous opacity. CDFI examination showed that 21 eyes (72.4%) had dendritic blood flow signal in 21 eyes (72.4%). In 13 eyes (92. 9%), the time-intensity curve was fast in and out. Conclusion: ultrasonic examination of grape metastatic carcinoma has some characteristic features, which can provide reliable basis for diagnosis and differential diagnosis.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院北京同仁眼科中心眼內(nèi)腫瘤診治研究北京市重點(diǎn)實(shí)驗(yàn)室北京市眼科學(xué)與視覺(jué)科學(xué)重點(diǎn)實(shí)驗(yàn)室;
【基金】：國(guó)家自然科學(xué)基金(No:81570891) 北京市自然科學(xué)基金(No:7151003) 北京市醫(yī)院管理局“登峰”人才培養(yǎng)計(jì)劃(No:DFL20150201);北京市醫(yī)院管理局臨床醫(yī)學(xué)發(fā)展專(zhuān)項(xiàng)經(jīng)費(fèi)資助(揚(yáng)帆計(jì)劃)(No:ZYLX201307) 眼內(nèi)腫瘤診治研究北京市重點(diǎn)實(shí)驗(yàn)室2015年度科技創(chuàng)新基地培育與發(fā)展專(zhuān)項(xiàng)項(xiàng)目(No:Z151100001615052) 北京市衛(wèi)生系統(tǒng)高層次衛(wèi)生技術(shù)人才培養(yǎng)計(jì)劃(No:2014-2-003)
【分類(lèi)號(hào)】：R445.1;R739.7

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