B型超声及彩色多普勒超声在眼内肿瘤诊断和鉴别诊断中的应用

目的探讨各种眼内肿瘤B型超声和彩色多普勒成像(CDI)检查的声学特征和血流特点。方法对我院1995年1月至2006年12月诊治的128例眼内肿瘤患者的临床资料、B型超声和CDI图像进行对比分析。其中包括脉络膜恶性黑色素瘤58例、视网膜母细胞瘤58例、脉络膜转移癌7例、睫状体髓上皮瘤3例及脉络膜血管瘤2例。结果扁平形脉络膜黑色素瘤在B型超声上容易与脉络膜血管瘤相混淆,可根据CDI显示的血流信号进行鉴别;脉络膜转移癌在B型超声上可表现为双峰状隆起,此征在其他肿瘤未曾见到,可作为其特征性改变;B型超声未发现实体性肿瘤,而临床检查发现前房积脓、虹膜结节以及前房、玻璃体内絮状渗出的儿童患者,有视网膜母细胞瘤的可能性。结论联合应用B型超声和CDI检查对眼内肿瘤的诊断和鉴别诊断有一定的价值。

Significance of B-mode and color Doppler imaging in diagnosis and differential diagnosis of intraocular tumors

Objective Acoustic and blood flow features of B-mode and color Doppler imaging(CDI)of various intraocular tumors were analysed to determine their role in the diagnosis and differential diagnosis.Methods Clinical data,B-mode and CDI in 128 patients with intraocular tumors were reviewed and compared.We found 58 cases with choroidal melanoma,58 with retinoblastoma,7 with choroidal metastasis,3 with ciliary medulloepithelioma and 2 with choroidal hamangioma.Results Flat choroidal melanoma would be confused with choroidal hamangioma on B-mode,which could be identified according to blood flow signals;Bi-peak contour was displayed in choroidal metastases,which was never seen in the other tumors,and would be regarded as its characteristics.Younger patients without tumors on B-mode,however,hypopyon,iris nodules and flocoular exudation in the anterior chamber and vitreous body were existed,it could be regarded as the possibility of retinoblastoma.Conclusions It is valuable for diagnosis and differential diagnosis of intraocular tumors to combine B-mode and CDI.