脉络膜黑色素瘤及脉络膜转移癌的临床影像学分析

Clinical imaging analysis of choroidal melanoma and choroidal metastatic oarcinoma

目的观察脉络膜黑色素瘤及脉络膜转移癌的临床影像学特征,提高两种肿瘤的诊断率。方法回顾性分析21只眼的临床资料,患者行直接检眼镜、FFA、B超、CT等检查。结果B超、CT、MRI在脉络膜肿瘤诊断方面无明显差异,但CT、MRI定位诊断优于B超;B超、MRI对脉络膜黑色素瘤的诊断优于CT;MRI对肿瘤眼外侵犯显示更为清晰;而CT对肿瘤密度的诊断则明显优于B超、MRI。FFA对脉络膜肿瘤的诊断有一定意义,但对临床表现不典型的病例,FFA仍有局限性。结论脉络膜黑色素瘤及脉络膜转移癌的影像学特征,有助于临床上发现和鉴别脉络膜原发肿瘤。

Objective To observe the clinical and imageology characteristics of choroidal melanoma and choroidal metastatic carcinoma, and to elevate the diagnosis rate of the two tumors. Methods The clinical data of 21 eyes of 21 patients were analyzed retrospectively, the patients were examined by direct ophthalmoscope, fluorescein fundus angiography （FFA）, B-mode ultrasonography, CT and so on. Results There was no obviously difference between CT and MRI in finding the tumor of choroid, but CT and MRI were superior to B-mode uhrasonography in level diagnosis. B-mode uhrasonography and MRI were superior to CT in diagnosis of melanoma of choroid; It was more clearly in tumor offending the outside of eye with MRI; CT was superior to B-mode ultrasonography and MRI in diagnosis of density of tumor. FFA was localized in the patients with atypical example clinical manifestation. Conclusion Be familiar with the imaging features of choroidal melanoma and choroidal metastatic carcinoma can help to find and identify the primartumor of choroid.