不同脉络膜肿瘤光学相干断层扫描影像学特征分析

目的观察不同脉络膜肿瘤,包括脉络膜黑色素瘤、脉络膜骨瘤、脉络膜转移癌及脉络膜血管瘤,在OCT中的影像学特征。方法收集2016年1月至2018年9月在云南省第二人民医院眼科就诊的脉络膜肿瘤患者36例(42眼)的临床资料,其中脉络膜黑色素瘤4例(4眼)、脉络膜血管瘤12例(12眼)、脉络膜转移癌10例(14眼)、脉络膜骨瘤10例(12眼),分析不同肿瘤的OCT影像学特征。结果脉络膜黑色素瘤4眼,OCT均表现为视网膜下多个团状高反射信号,视网膜各层组织被破坏。脉络膜转移癌14眼,OCT表现为脉络膜崎岖不平、波浪状改变,其下隐约可见脉络膜小血管形态,视网膜神经上皮层与色素上皮层脱离,视网膜外层组织内可见大量细颗粒状、团状高反射物堆积。脉络膜骨瘤12眼,10眼OCT示脉络膜层次内一个网状反射影像信号,此处结构与周围脉络膜血管结构完全不同,其后组织反光被遮挡。脉络膜血管瘤12眼,OCT均表现为视网膜下脉络膜隆起,表面光滑,视网膜色素上皮层下反射信号均匀。结论 OCT可作为一项安全有效的眼底影像学检查手段对不同脉络膜肿瘤形态进行观察,结合其他眼底检查手段可为脉络膜肿瘤的诊断和鉴别诊断提供依据。

Characteristic analysis for optical coherence tomography images of choroidal neoplasms

Objective To observe the imaging features of choroidal neoplasms including choroidal melanoma,choroidal osteoma,choroidal metastasis and choroidal hemangioma in OCT.Methods The study was conducted for analysis on clinical data of 36 cases(42 eyes)diagnosed with choroidal neoplasms at the Department of Ophthalmology,the Second People’s Hospital of Yunnan Province,from January 2016 to September 2018.There were 4 cases of choroidal melanoma(4 eyes),12 cases of choroidal hemangioma(12 eyes),10 cases of choroidal metastases(14 eyes),10 cases of choroidal osteoma(12 eyes),OCT imaging features of which were analyzed.Results In the 4 eyes of choroidal melanoma,OCT showed multiple bulk high-reflection singles,and all retinal layers were broken.In 14 eyes of choroidal metastasis,OCT showed rugged and wavy bulges in choroid,and choroidal small vessels was faintly visible.The retinal neuroepithelial layer was separated from the pigment epithelial layer,and a large number of fine-grained,lumpy-like high-reflection materials were observed in retinal outer layers.In 12 eyes of choroidal osteoma,OCT showed a reticulated image signal in the choroidal layer of 10 eyes,where the structure was completely different from the surrounding choroidal vascular structures,and then the tissue reflection was blocked.In 12 eyes of choroidal hemangioma,OCT showed subretinal choroidal bulges,smooth surface and uniform pigment epithelial reflex signals.Conclusion OCT can be used as a safe and effective fundus imaging method to observe the morphological manifestations of various choroidal tumors.Combined with other fundus examination methods,it provides a basis for the diagnosis and differential diagnosis of choroidal tumors.