应用共聚焦激光扫描血管造影技术诊断孤立性脉络膜血管瘤

Application of scanning laser angiography technique in diagnosis of circumscribed choroidal hemangiomas

目的评价激光扫描血管造影技术在诊断孤立性脉络膜血管瘤中的应用价值。设计回顾性病例系列。研究对象临床诊断为疑似脉络膜血管瘤35例患者。方法对临床疑似为脉络膜血管瘤患者35例,彩色眼底照相后,行30°及150°视野共聚焦激光扫描血管造影检查。主要指标共聚焦激光扫描血管造影的成像特征。结果荧光素眼底血管造影(FFA)特征为所有35例患者动脉前期或动脉期即显荧光,至动静脉期荧光增强、融合,荧光素渗漏,其间夹杂斑点状弱荧光;静脉早期瘤体呈多湖状,可见血管网形态,晚期荧光素渗漏呈强荧光区。吲哚氰绿血管造影(ICGA)早期可清晰显现瘤体由脉络膜血管团组成,随后染料渗漏,荧光增强,融合呈强荧光灶。150°广角视野共聚焦激光扫描眼底成像提供了瘤体的整体形态。结论激光扫描血管造影技术中FFA和ICGA同步造影及全景造影为孤立性脉络膜血管瘤诊断提供更多的信息。

Objective To evaluate the applicable value of scanning laser angiography technique in diagnosis of circumscribed choroidal hemangiomas. Design A retrospective case series study. Participants 35 cases who have been suspected clinically as circumscribed choroidal hemangiomas. Methods Fundus fluorescein angiography（FFA ）, indocyanine green angiography （ ICGA ） and scanning laser ophthalmology technique were performed in 35 cases who had been suspected clinically as circumscribed choroidal hemangiomas, their imaging data were analyzed. Main Outcome Measures Scanning laser angiography technique, imaging data. Results Satisfactory imaging data were acquired in these 35 cases. FFA showed filling at the early stage in the hemangiomas, then the fluorescence intensified and leaked from the tumors, and spotted hypofluorescence was seen at the transit frame. During the early vein frame, the tumors showed multiple lake shape, vessels networks were noticed. The fluorescence leaked and hyperfluorescence of the tumor were apparently found at the late frame. ICGA showed the hemangiomas were composed of irregular choroidal vasculature. Then the fluorescence leaked and intensified to form hyperfluorescence. The sizes of these tumors measured by 30° visual fields were 3.06mm×2.87mm- 10.97mm×12.63mm （average 11.54±9.37 mm^2）. Compared with color fundus graph and FFA, ICGA showed clearly the boundary and size of the tumors. The whole structure of the tumors was provided by 150°visual fields and scanning laser angiography. Conclusion ICGA and FFA of scanning laser ophthalmology and whole fundus angiography had important applicable value in diagnosis of choroidal hemangiomas. （ Ophthalmol CHN, 2006, 15：258-261 ）