视盘黑色素细胞瘤的超声特征分析

Analysis of ultrasonic features of melanocytoma of optic disc

目的探讨视盘黑色素细胞瘤(MCOD)的超声形态、超声造影特点,观察随访结果。方法回顾性分析2012年9月至2020年12月首都医科大学附属北京同仁医院眼科中心收治的MCOD患者35例(35只眼,35个病灶),分析病灶的超声检查形态、大小、内部回声、边界、伴随表现、病变内部血流灌注情况等。其中13例患者行超声造影检查,9例患者进行了随访观察。结果形态:6个病灶(17.1%)超声表现为视盘前半球形强回声,29个病灶(82.9%)表现为视盘前局限隆起强回声;大小:病灶最大基底径(4.0±0.8)mm,高度(1.9±0.4)mm;内部回声:8个病灶(22.9%)内部回声均匀,27个病灶(77.1%)内部回声欠均匀;边界:35个病灶(100%)边界均清晰;伴随表现:15个病灶(42.9%)伴有不同程度的玻璃体混浊;彩色多普勒血流成像示:19个病灶(54.3%)内可见与视网膜中央动脉、静脉相延续的血流信号,16个病灶(45.7%)内未见异常血流信号;超声造影检查:13个病灶中11个(84.6%)内可见造影剂微泡填充。结论超声检查可为临床诊断MCOD提供可靠的诊断和鉴别诊断依据。

Objective To investigate the ultrasonic features,contrast-enhanced ultrasound findings and long-term follow-up results of melanocytoma of the optic disc(MCOD).Methods The data of 35 patients(35 eyes,35 lesions)diagnosed with MCOD in Beijing Tongren Ophthalmic Center,Beijing Tongren Hospital from September 2012 to October 2020 were retrospectively analyzed.The B-mode ultrasonography and color Doppler flow imaging(CDFI)were performed on them.The size,morphology,internal echo and secondary changes of the lesions were analyzed.Contrast-enhanced ultrasound was performed on 13 patients.At the same time,9 patients were followed up for long-term observation.Results Six lesions(17.1%)showed hemispherical high echo,and 29 lesions(82.9%)showed limited uplift high echo.The largest base diameter of the lesions was(4.0±0.8)mm,average height was(1.9±0.4)mm.Internal echo characteristics:8 lesions(22.9%)showed uniform echo and 27 lesions(77.1%)showed uneven echo.Lesion boundary:35 lesions(100%)showed clear lesion boundary.Fifheen lesions(42.9%)showed secondary vitreous opacity.CDFI:blood flow signals could be detected inside the lesions in 19 lesions(54.3%),and not in 16 lesions(45.7%).Contrast-enhanced ultrasound showed 11 of the 13 lesions(84.6%)were completely filled with contrast agent.Conclusions MCOD has certain ultrasonographic characteristics,which can provide a reliable basis for clinical diagnosis and differential diagnosis.There is no significant change in tumor size after long-term follow-up.