脉络膜黑色素瘤的超声影像分析

Analysis of the ultrasonographic features of choroidal melanoma

目的分析脉络膜黑色素瘤超声影像表现,探讨超声在脉络膜黑色素瘤诊断中的影像学价值。方法回顾性病例研究。选取2013年8月至2020年10月在河北省眼科医院就诊的脉络膜黑色素瘤患者45例(45只眼),对术后经病理确诊为脉络膜黑色素瘤患者的超声影像特征进行分析。其中男性25例(25只眼),女性20例(20只眼),最小年龄28岁,最大年龄87岁,平均年龄59.3岁。结果超声影像显示:本组病例肿瘤基底部直径:最小5.5 mm,最大25 mm,平均12.7 mm;隆起高度最低2.1 mm,最高23 mm,平均9.9mm。肿瘤位置:颞侧25例(25只眼),鼻侧11例(11只眼),上方3例(3只眼),下方2例(2只眼),后极部4例(4只眼)。肿瘤形态:蕈状16例(16只眼),球形、圆顶状21例(21只眼),哑铃状3例(3只眼),不规则形5例(5只眼,其中1例肿瘤侵犯巩膜、视神经及眶内软组织)。影像学特征:挖空征(声衰减)32例(32只眼),脉络膜凹陷征26例(26只眼)。继发改变:伴发视网膜脱离37例(37只眼),玻璃体混浊(积血)10例(10只眼)。结论脉络膜黑色素的超声表现有较特异性的影像学特征。超声为脉络膜黑色素的诊断与鉴别诊断提供重要的影像学价值。

Objective To analyze the ultrasonographic manifestations of choroidal melanoma and discuss the value of ultrasonography in the diagnosis of choroidal melanoma.Methods Retrospective case study.A total of 45 patients(45 eyes)with choroidal melanoma from August 2013 to October 2020 at the Hebei Eye Hospital were selected for the retrospective analysis.The patients were pathologically diagnosed as choroid melanoma.There were 25 males(25 eyes)and 20 females(20 eyes).The youngest patient was 28 years old,the oldest was 87 years old,and the average age was 59.3 years.Results Ultrasound imaging showed that the diameter of tumor base in this study ranged from 5.5 mm to 25 mm,with a mean of 12.7 mm.The height of the tumor ranged from 2.1 mm to 23 mm,with a mean of 9.9 mm.Regarding the tumor location,25 cases(25 eyes)were in the temporal quadrant,11 cases(11 eyes)were in the nasal quadrant,3 cases(3 eyes)were in the superior quadrant,2 cases(2 eyes)were in the inferior quadrant,and 4 cases(4 eyes)were located at the posterior pole.Regarding the tumor morphology,16 cases showed mushroom shape(16 eyes),21 cases showed spherical and dome-shaped shape(21 eyes),3 cases showed dumbbell shape(3 eyes),5 cases showed irregular shape(5 eyes,1 case showed tumor invasion of the sclera,optic nerve and orbital soft tissue).Regarding the imaging features,32 cases(32 eyes)showed acoustically hollow(acoustic attenuation),26 cases(26 eyes)showed choroid excavation.Regarding the secondary changes,37 cases(37 eyes)had retinal detachment,10 cases(10 eyes)had vitreous opacity(hemoptysis).Conclusions The ultrasonographic manifestations of choroidal melanoma have specific imaging characteristics.Ultrasound provides important value in the diagnosis and differential diagnosis of choroidal melanoma.