脉络膜转移癌的眼底血管造影

Fundus angiography in metastatic carcinomas of choroid

目的 了解脉络膜转移癌的两种血管造影表现特征。 方法 在 17例 2 4只患眼 ,采用荧光素眼底血管造影 (fundus fluorescein angiography,FFA)和吲哚青绿血管造影 (indocyanine green angiogarphy,ICGA)检查 ,将两种造影图像进行对比分析。 结果 根据转移至眼底部位、时间、肿瘤种类 ,眼底造影表现分为 (1)孤立型 :FFA检查瘤体在弱背景荧光下渐出现针尖样点状荧光 ,晚期荧光增强融合呈斑驳样荧光 ,ICGA表现和 FFA相似 ,但荧光出现较晚 ,有时可见一强荧光边 ,如肿物薄扁 ,则通过肿物如同透镜 ,可透见下面的脉络膜血管。 (2 )弥漫型 :两种造影显示早期瘤体遮挡荧光 ,晚期呈不均匀强荧光。 (3)小转移癌 :两种造影检查瘤体早期不显荧光 ,晚期呈弱点状荧光。 结论 两种造影检查对诊断均有帮助 ,如 FFA诊断有困难 ,ICGA可协助诊断。

Objective To evaluate the characteristics of two angiographic manifestation of ocular fundus in choroidal metastatic carcinomas. Methods Fundus fluoresein angiography (FFA) and indocyanine green angiography (ICGA) were performed on 17 patients (24 eyes) with choroidal metastatic carcinomas, and the characteristics of these two kinds of angiograms were analyzed and compared each other. Results According to various clinical features, e.g., locations of metastatic tumor in ocular fundus, disease course, and different kinds of original malignancy, the findings of ocular fundus were divided into (1) Isolation type: FFA showed pinpoint and mottled leaks against hypofluorescence background, increased and confluent fluoresecence in later stage. ICGA showed the similar images as in FFA, except later appearance of leaks and the choroidal vesseles could be seen beneath the thin metastatic tumor mass.(2) Diffusion type: Tumors showed hypofluorescence in early stage and uneven ill defined hyperfluorescence both in FFA and in ICGA. (3) Small metastatic carcinomas: Hypofluorescence in early stage and mild mottled hyperfluorescence were found in FFA as well as in ICGA. Conclusion Both FFA and ICGA are helpful in the diagnosis of choroidal metastatic tumors and ICGA may be conducive if there are some troubles in diagnosing the tumors with FFA.