B型超声在婴幼儿视网膜母细胞瘤诊断及治疗跟踪中的应用

Application of B-ultrasound in the diagnosis and treatment of infantile retinoblastoma

目的研究婴幼儿视网膜母细胞瘤(RB)的超声影像学特点及B型超声在RB治疗跟踪中的应用。方法对临床检查、广域眼底成像术(RetCam)、B型超声、CT、核磁共振检查确诊为RB的患儿,对其超声图片的超声影像学特征进行分析,并应用B型超声对治疗过程中肿瘤的变化进行跟踪监测以观察疗效。结果小的RB肿瘤表现为玻璃体腔内轻度隆起的中强回声病灶,较大肿瘤表现为后极部丘状、类圆形隆起的占位病灶,病灶内部或表面常可见钙化点或钙化斑。肿瘤进一步增大时瘤体无规则形状,甚至充满整个玻璃体腔。常可见到散在的斑点状或斑片状强回声钙化灶,后伴声衰减,少见视网膜脱离表现。RB经过综合治疗后,瘤体缩小钙化,回声明显增强。结论RB是一种危害患儿生命的严重眼病,常规B型超声因为其普及性、便利性、无需患儿麻醉等优点,在临床诊断及疾病治疗随访过程中起着重要作用。

Objective To study the ultrasonographic characteristics of infantile retinoblastoma(RB)and the application of B-ultrasound in the follow-up of RB treatment.Methods The ultrasonographic characteristics of RB in children diagnosed by clinical examination,RetCam,B-ultrasound,CT and nuclear magnetic resonance(MRI)were analyzed,and the changes of tumors in the course of treatment were monitored by B-ultrasound to observe the treatment effect.Results Small RB tumors manifested as moderately hyperechoic lesions with mild intravitreal eminence,while larger tumors presented as hilly,round space-occupying lesions in the posterior pole.Calcification spots or calcification plaques were often seen inside or on the surface of the lesions.When the tumor was further enlarged,the shape of the tumor became irregular,or even filled the whole vitreous cavity.Spotted or patchy hyperechoic calcifications can be commonly seen,followed by acoustic attenuation,and retinal detachment is rare.After comprehensive treatment of RB,the tumor was reduced and calcified,and the echo was obviously enhanced.Conclusions RB is a serious eye disease that endangers children's life.Routine B-ultrasound plays an important role in the clinical diagnosis and follow-up of disease treatment due to the advantage of popularity,convenience and no need of anesthesia for children.