B超等影像检查在脉络膜血管瘤诊断中的应用

Application of B ultrasound in diagnosis of choriodal hemangioma

目的探讨B超等(CT和MR)影像检查对于脉络膜血管瘤的诊断价值。方法回顾分析经临床证实的脉络膜血管瘤11例病例资料,均行B超检查,其中行CT增强扫描1例、MR检查4例、眼底血管荧光造影2例。结果 11例B超检查呈梭形或橄榄形高回声占位,其中肿块实质均质8例,呈实质不均质占位3例;CT增强扫描示后极部球壁增厚1例,密度均匀,强化明显;MRI4例中T1WI呈等信号3例,T1WI呈高信号1例,T2WI均呈高信号,4例增强后瘤体显著强化。眼底血管荧光造影2例均显示动脉早期窦状强荧光,静脉期荧光渗漏,晚期瘤体高荧。结论 B超、增强CT和MRI对脉络膜血管瘤可作出定位的影像学诊断,B超(+眼底血管荧光造影)在早期诊断方面有一定优势,MRI对该病的诊断及鉴别诊断较具特征性。

Objective To evaluate the application of ultrasonography,CT and MRI in the diagnosis of choroidal hemangioma. Methods 11 choroidal hemangioma patients confirmed clinically were reviewed. All cases were examined by ultrasound and 2 received extra fundus fluorescein angiography （FFA）. CT scan was performed in 1 case and MRI in 4 cases. Results Ultrasound showed shuttle-or olive-shaped,strong echo mass （n=11）,homogeneous （n=8） or inhomogeneous mass （n=3）. 1 case,on enhanced CT images,showed thickening on the posterior funder wall of the eyeball,with equal density and marked enhancement. On MRI T1WI （n=4）,3 cases presented equal signal intensity,but one revealed high intensity. On T2WI,all 4 cases presented high signal intensity with marked enhancement. In 2 cases that underwent FFA,antral hyperfluorescence in the early arterial phase,fluorescence leakage at the venous phase and hyperfluorescence in the late tumor stage was found. Conclusions B-ultrasonography,enhanced CT and MRI can help reach the diagnosis and locate choroidal hemangioma. B-ultrasound （＋FFA） shows advantage in early diagnosis while MRI imaging features in the diagnosis and differentiation.