视网膜母细胞瘤的B超声像图与病理诊断对照分析

目的 探讨视网膜母细胞瘤的超声图像特征与病理诊断的关系，旨在提高RB超声定性诊断的准确性。方法 本文采用法国产BVI眼科专用A／B超声诊断仪，对98例视网膜母细胞瘤进行超声探查，全病例均经手术及病理证实，并逐一进行对照分析。结果 全病例超声图像与病理诊断完全相符，即声像图显示玻璃体腔内实质性肿块回声的93例（93／98，94．9％）病变部位瘤细胞丰富排列较紧密；86例（86／98，87．8％）可见散在的斑点状强回声，部分伴有声影，而组织病理学检查可见明显钙化；49例（49／98，50．0％）声像图显示在肿物回声的后方有一线样的强回声带，与肿物发生粘连，为继发性视网膜脱离；38例（38／98，38．8％）肿物回声团内出现形态不规则的弱回声或无回声区（暗区），为细胞稀少或有坏死、液化表现；27例（27／98，27．6％）可探及眼球后壁回声欠清，视神经回声带增宽，则提示肿瘤有向眶内或颅内转移的可能；5例（5／98，5．1％）肿瘤呈囊性型回声。则多提示晚期病灶。结论 B超在视网膜母细胞瘤的临床诊断及鉴别诊断中有极高的应用价值。

Comparative Analysis of B-ultrasonogram of retinoblastoma and Their Phathologic Diagnosis

Objective To study the relationship between the sonographic features and pathologic of retinoblastoma and to improve the accuracy of the ultrasound diagnosis for these diseases.Methods 98 cases with retinoblastoma were examined with BVI ultrasonoscope and their diagnosis were confirmed by operation and pathology and analysed comparatively.Results Ultrasound manifestations of all the cases conformed to the pathologic diagnosis.The ultrasonic manifestations included solid mass in vitreous in 93 cases(93/98,94.9%),86 cases(86/98,87.8%)with sporadic spot strong echo,partly with echo shadow,pathologic examination findings were obvious calcification.There were thready strong echo at the back of tumor and associated with retinal detachment in 49 cases(49/98,50.0%).And there is a solid intraocular echo corresponding to the tumor and within it are numerous irregular weak echoes or no echoes(darkspace)showing sparse cells or necrosis,liquidation.In 27 cases(27/98,27.6%),findings were unclear echos in the posterior eyeball,increasing echo zones of optic nerve,suggesting orbit and cranium metastasis.In 5cases(5/98,5.1%),cystic echos within tumors showed advanced stage.Conclusions B-ultrasonography contributes well to the clinical and differential diagnosis of retinoblastoma.