年龄相关性黄斑变性的彩色多普勒超声影像特征

Analysis of changes of color Doppler flow imaging in age-related macular degeneration

目的 探讨年龄相关性黄斑变性(AMD)患者的彩色多普勒血流成像(CDFI)超声影像特征。方法 应用CDFI超声诊断仪检测98例AMD患者,观察、分析其CDFI影像特征,并与脉络膜黑色素瘤、脉络膜转移癌、脉络膜黑色素细胞瘤、黄斑水肿等疾病相鉴别。结果 干性AMD患者的CDFI影像特征:多数患者经CDFI超声检测无特殊发现,部分患者CDFI影像中可见黄斑区球壁回声局限隆起,但隆起高度一般不超过1 5mm,病变内可见边界清晰的点状强回声,基底部血流信号较丰富。湿性AMD患者的CDFI影像特征:黄斑区呈现半球形或不规则形实性病变,边界清晰,但不规则,内回声均匀为中强回声,无脉络膜凹陷;病变的基底部可探及较丰富的血流信号,表面可探及点状、带状血流信号,病变内部无异常血流信号。应用CDFI诊断干性和湿性AMD患者,关键在于黄斑区病变的形态、边界、内部回声、玻璃体内有无同时合并玻璃体混浊(积血)等。依据AMD患者的CDFI影像特征和血流形态,可与脉络膜黑色素瘤、脉络膜转移癌、脉络膜黑色素细胞瘤、黄斑水肿等疾病相鉴别。结论 应用CDFI检测AMD患者的方法简便、诊断准确,值得临床推广应用。

Objective To study the specific imaging of age-related macular degeneration (AMD) by color Doppler flow imaging (CDFI). Methods Routine CDFI was carried out in 98 cases of AMD to observe the character of blood flow in AMD, to establish the diagnosis criteria of different types of AMD and to different the AMD from malignant choroidal melanoma, metastatic carcinoma of the choroid, choroidal nevus and macular edema. Results CDFI in dry form AMD did not detect changes in most patients, mildly elevated lesions presented in some cases. In wet form of AMD, CDFI showed solid lesion with irregular surface contour. The internal structure of these lesions was middle degree. Choroidal excavation was not found. Numerous blood flow signals could be found at the base of the lesion. Spot blood flow signals were present on the surface of the lesion. There was no abnormal blood flow signal in the mass. The different acoustic properties between wet form and dry form included configuration, surface and internal structure, with or without vitreous hemorrhage. Conclusion CDFI is a simple and reliable method in the diagnosis of AMD.