摘要
目的 探讨脉络膜肿瘤的临床特征和核磁共振、超声波、荧光素眼底血管造影（FFA）和吲哚青绿眼底血管造影（1CGA）等影像学检查的诊断价值.方法 对2008年1月至2009年12月在中山大学中山眼科中心经作者诊治住院的22例脉络膜肿瘤患者进行同顾性分析.全部病例行眼部B超和（或）彩色超声波检查,屈光间质透明者行FFA和ICGA检查；部分病例行双眼MRI或CT检查.所有原发性恶性肿瘤病例均行眼球摘除术；眼内转移癌患者治疗原发病,或加作眼局部外放射治疗；脉络膜m管瘤则经临床检查确诊后,行眼内激光或光动力治疗.结果 12例脉络膜恶性黑色素瘤外观和影像检查多表现为眼内棕黑色磨菇形或球形隆起肿物,MRI检查均特征性地表现为TlWI高信号,T2WI低信号.7例脉络膜海绵状血管瘤多表现为后极部扁平桔红色肿物,ICGA/FFA表现为早期即见强荧光,具有诊断性特征；MRI检查表现为T1WI低或中等信号,T2WI与玻璃体等信号或高信号,可被明显强化.3例脉络膜转移癌表现为后极部灰黄色扁平隆起肿物,均有原发肿瘤病史,其中1例为双眼发病.结论 屈光间质透明者,常规眼底检查即可基本明确脉络膜肿瘤的诊断.FFA/ICGA检查对明确脉络膜血管瘤意义重大.屈光间质混浊时,核磁共振和超声检查在脉络膜肿瘤的诊断中具有重要的诊断价值.
Objective To investigate the clinical findings and diagnostic value of MRI,ultrasonography fundus fluorescein angiography （FFA） and indocyanine green angiography （ICGA） in patients with choroidal neoplasms. Methods In this retrospective study,the clinical data of 22 patients with choroidal neoplasm treated in Zhongshan Ophthalmic Center,Sun Yat-sen University from January 2008 to December 2009 was collected and analyzed.All patients were examined by ultrasound type-B and color Doppler scan.Some of them received FFA,ICGA,CT and MRI examinations.The patients with primary malignant tumor were treated with enucleation.The patients with choroidal metastasis were referred to tumor hospital and usually had systemic chemotherapy and local radiotherapy.The patients with choroidal hemangiomas usually received retinal photocoagulation or photodynamic therapy except those with uncontrolled secondary glaucoma who often had enucleation. Results The imaging of 12 patients with choroidal malignant melanoma showed typical globular or mushroom-shaped intraocular mass with brown or black color.MR1 examination revealed high signal intensities on TlWI and low signal intensities on T2WI.Flat orange-red neoplasm in the posterior pole was the main clinical characteristics of choroidal hemangioma in 7 patients.In the early phase,hyperfluorescence was observed in choroidal hemangioma with FFA/ICGA.MRI revealed low or medium signal intensity on TlWI and high signal intensity on T2WI,with high enhancement.Three cases of choroidal metastasis usually demonstrated flat gray-yellow intraocular mass in posterior pole,all of them had the primary systemic tumor in our case series,and one patient was involved bilaterally. Conclusions The diagnosis of choroidal neoplasm often can be confirmed through detail routine fundus examination in eyes with refractive media transparency.FFA/ICGA is highly valuable in the diagnosis of choroidal hemangioma.MRI and ultrasound examination contributes well to the diagnosis of choroidal neoplasm in eyes with
出处
《中国实用眼科杂志》
CSCD
北大核心
2012年第2期141-145,共5页
Chinese Journal of Practical Ophthalmology
基金
广东省自然科学基金重点项目（036651）
