应用标准化A型超声诊断眼眶肿瘤

目的探讨标准化A型超声在眼眶肿瘤诊断中的应用价值.方法应用标准化A型超声对72例眼眶肿瘤,包括海绵状血管瘤、泪腺多形性腺瘤、泪腺腺样囊性癌、神经鞘瘤、血管外皮瘤、黏液囊肿和横纹肌肉瘤等病变进行检查,分析并总结图像特征,测量平均内反射百分比(Q-I值),并经病理结果验证.结果标准化A型超声通过病变反射波峰的高低、内部结构是否规则、声衰减程度等提示病变性质.每种肿瘤有独特的图像表现,入、出反射波峰间的Q-I值各不相同.海绵状血管瘤呈中高波峰,平均Q-I值25%,均匀衰减.泪腺多形性腺瘤衰减明显,前1/2段波峰陡峭下降,后1/2段为中低波峰,平均Q-I值16%.泪腺腺样囊性癌衰减明显,基线前1/3段波峰陡峭下降,后2/3段为低波峰,间杂中波峰或无波峰.平均Q-I值12%.神经鞘瘤为中低波峰,间杂无波峰的平段.平均Q-I值9%.血管外皮瘤为甚低波峰,间杂无波峰的平段.平均Q-I值5%.横纹肌肉瘤为无波峰的平段,无明显声衰减.间杂甚低波峰.平均Q-I值2%.黏液囊肿在入肿瘤波峰前有少许中高波峰,内回声为均一的平段,无声衰减,平均Q-I值0.结论标准化A型超声对于眼眶肿瘤的诊断具有一定参考价值,具有一定的鉴别诊断意义.

Application of standardized A-ultrasonic scan for the diagnosis of orbital tumors

Objective To investigate the value of standardized A-ultrasonic scan in the diagnosis of orbital tumors. Methods Standardized A-ultrasonic scan was performed in 72 cases of orbital tumors, including cavernous hemangioma, pleomorphic adenoma of lacrimal gland, adenoid cystic carcinoma of lacrimal gland, neurilemmoma, hemangiopericytoma, rhabdomyosarcoma and mucocele. The characteristics of images were analyzed and the average values of Q-I were measured, and were confirmed by pathologic examination. Results Using standardized A-ultrasonic scan we could understand the nature of tumors by the acoustic criteria, including the internal structure, reflectivity and sound attenuation. Each kind of tumor had characteristic image and the value of Q-I. Cavernous hemangioma showed middle or high echospikes and regular sound attenuation, with the average value of Q-I being 25%. Pleomorphic adenoma of lacrimal gland showed marked sound attenuation, anterior half of echospike sharp attenuating, the rest being middle or low echospikes, with the average value of Q-I being 16%. Adenoid cystic carcinoma showed marked sound attenuation, anterior one third echospike sharp attenuating, the rest being low echospikes with intermittent middle or no spike; the average value of Q-I was 12%. Neurilemmoma showed middle or low reflectivity with inter- mittent no echospike on the baseline; the average value of Q-I was 9%. Hemangiopericytoma showed very low reflectivity with no echospike on the baseline; the average value of Q-I was 5%. Rhabdomyosarcoma showed no echospike on the baseline with a few very low echospikes ; the average value of Q-I was 2%. Mu- cocele showed a few middle or high spikes before the echospike entered the tumor with no echospike on the baseline; the average value of Q-I was 0. Conclusions Standardized A-ultrasonic scan proves to be an effective method in diagnosing and differentiating orbital tumors.