中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
Chinese Journal of Experimental Ophthalmology
2015年
11期
1028-1032
,共5页
柏刚%武犁%李蓬%陈辽%陈文卫
柏剛%武犛%李蓬%陳遼%陳文衛
백강%무리%리봉%진료%진문위
眼眶肿瘤/超声检查法%影像增强/方法%对比剂%超声检查/方法%鉴别诊断%人
眼眶腫瘤/超聲檢查法%影像增彊/方法%對比劑%超聲檢查/方法%鑒彆診斷%人
안광종류/초성검사법%영상증강/방법%대비제%초성검사/방법%감별진단%인
Orbital neoplasms/ultrasonography%Image enhancement/methods%Contrast media%Ultrasonography/methods%Diagnosis,differential%Humans
背景 眼眶肿瘤因其复杂的组织病理学类型,临床上鉴别诊断相对困难,亟需利用新的诊断学技术鉴别其良恶性. 目的 分析眼眶肿瘤患者的超声造影特点,比较眼眶良性肿瘤和眼眶恶性肿瘤的增强模式及增强类型的差异,评价超声造影对眼眶肿瘤的诊断价值. 方法 对2010年9月至2013年9月在湖北医药学院附属太和医院确诊的眼眶恶性肿瘤患者24例和眼眶良性肿瘤51例的临床资料进行回顾性分析.所有患者术前在口头知情同意下采用MyLab Twice型彩色超声诊断仪进行超声造影检查,患者由肘静脉注射2.0 ml SonoVue造影剂,收集眼眶肿瘤造影的静态和动态图像,用SonoLiver分析软件进行分析,参考《超声造影临床应用指南》中关于肝脏超声造影的增强水平和增强模式的分类方法对眼眶肿瘤超声造影的特点进行分析,总结不同组织学类型超声造影增强模式及增强类型特点,利用SonoLiver软件定量分析法获得时间-强度曲线(TIC)和动态血管模式(DVP)参数,比较眼眶恶性肿瘤与眼眶良性肿瘤的超声造影影像学特征.结果 按照增强强度分型法发现,眼眶恶性肿瘤和良性肿瘤中病灶出现高增强者百分比分别为62.5％(15/24)和27.5％ (14/51),等增强者百分比分别为20.8％ (5/24)和49.0％ (25/51),眼眶恶性肿瘤超声造影的增强水平明显高于良性肿瘤,差异有统计学意义(x2=26.40,P＜0.01).按照增强模式分型法发现,眼眶恶性肿瘤和良性肿瘤病灶非均匀性增强者百分比分别为75.0％ (18/24)和25.5％ (13/51),均匀性增强者百分比分别为25.0％ (6/24)和47.1％(24/51),眼眶恶性肿瘤病灶的非均匀增强比例明显高于良性肿瘤,差异有统计学意义(x2=30.40,P＜0.01).眼眶恶性肿瘤中58.3％的病灶TIC形态表现为快升快降型,75.0％的DVP曲线形态表现为正负双相波型,眼眶良性肿瘤中78.7％的TIC形态表现为快升慢降型,74.5％的DVP曲线形态表现为正向波型,不同曲线形态的眼数分布差异均有统计学意义(TIC:Z=-3.130,P=0.002;DVP:Z=-4.730,P=0.000).结论 超声造影检查显示不同组织病理学类型眼眶肿瘤增强方式及曲线形态不同,超声造影有助于眼眶恶性肿瘤与眼眶良性肿瘤的鉴别诊断.
揹景 眼眶腫瘤因其複雜的組織病理學類型,臨床上鑒彆診斷相對睏難,亟需利用新的診斷學技術鑒彆其良噁性. 目的 分析眼眶腫瘤患者的超聲造影特點,比較眼眶良性腫瘤和眼眶噁性腫瘤的增彊模式及增彊類型的差異,評價超聲造影對眼眶腫瘤的診斷價值. 方法 對2010年9月至2013年9月在湖北醫藥學院附屬太和醫院確診的眼眶噁性腫瘤患者24例和眼眶良性腫瘤51例的臨床資料進行迴顧性分析.所有患者術前在口頭知情同意下採用MyLab Twice型綵色超聲診斷儀進行超聲造影檢查,患者由肘靜脈註射2.0 ml SonoVue造影劑,收集眼眶腫瘤造影的靜態和動態圖像,用SonoLiver分析軟件進行分析,參攷《超聲造影臨床應用指南》中關于肝髒超聲造影的增彊水平和增彊模式的分類方法對眼眶腫瘤超聲造影的特點進行分析,總結不同組織學類型超聲造影增彊模式及增彊類型特點,利用SonoLiver軟件定量分析法穫得時間-彊度麯線(TIC)和動態血管模式(DVP)參數,比較眼眶噁性腫瘤與眼眶良性腫瘤的超聲造影影像學特徵.結果 按照增彊彊度分型法髮現,眼眶噁性腫瘤和良性腫瘤中病竈齣現高增彊者百分比分彆為62.5％(15/24)和27.5％ (14/51),等增彊者百分比分彆為20.8％ (5/24)和49.0％ (25/51),眼眶噁性腫瘤超聲造影的增彊水平明顯高于良性腫瘤,差異有統計學意義(x2=26.40,P＜0.01).按照增彊模式分型法髮現,眼眶噁性腫瘤和良性腫瘤病竈非均勻性增彊者百分比分彆為75.0％ (18/24)和25.5％ (13/51),均勻性增彊者百分比分彆為25.0％ (6/24)和47.1％(24/51),眼眶噁性腫瘤病竈的非均勻增彊比例明顯高于良性腫瘤,差異有統計學意義(x2=30.40,P＜0.01).眼眶噁性腫瘤中58.3％的病竈TIC形態錶現為快升快降型,75.0％的DVP麯線形態錶現為正負雙相波型,眼眶良性腫瘤中78.7％的TIC形態錶現為快升慢降型,74.5％的DVP麯線形態錶現為正嚮波型,不同麯線形態的眼數分佈差異均有統計學意義(TIC:Z=-3.130,P=0.002;DVP:Z=-4.730,P=0.000).結論 超聲造影檢查顯示不同組織病理學類型眼眶腫瘤增彊方式及麯線形態不同,超聲造影有助于眼眶噁性腫瘤與眼眶良性腫瘤的鑒彆診斷.
배경 안광종류인기복잡적조직병이학류형,림상상감별진단상대곤난,극수이용신적진단학기술감별기량악성. 목적 분석안광종류환자적초성조영특점,비교안광량성종류화안광악성종류적증강모식급증강류형적차이,평개초성조영대안광종류적진단개치. 방법 대2010년9월지2013년9월재호북의약학원부속태화의원학진적안광악성종류환자24례화안광량성종류51례적림상자료진행회고성분석.소유환자술전재구두지정동의하채용MyLab Twice형채색초성진단의진행초성조영검사,환자유주정맥주사2.0 ml SonoVue조영제,수집안광종류조영적정태화동태도상,용SonoLiver분석연건진행분석,삼고《초성조영림상응용지남》중관우간장초성조영적증강수평화증강모식적분류방법대안광종류초성조영적특점진행분석,총결불동조직학류형초성조영증강모식급증강류형특점,이용SonoLiver연건정량분석법획득시간-강도곡선(TIC)화동태혈관모식(DVP)삼수,비교안광악성종류여안광량성종류적초성조영영상학특정.결과 안조증강강도분형법발현,안광악성종류화량성종류중병조출현고증강자백분비분별위62.5％(15/24)화27.5％ (14/51),등증강자백분비분별위20.8％ (5/24)화49.0％ (25/51),안광악성종류초성조영적증강수평명현고우량성종류,차이유통계학의의(x2=26.40,P＜0.01).안조증강모식분형법발현,안광악성종류화량성종류병조비균균성증강자백분비분별위75.0％ (18/24)화25.5％ (13/51),균균성증강자백분비분별위25.0％ (6/24)화47.1％(24/51),안광악성종류병조적비균균증강비례명현고우량성종류,차이유통계학의의(x2=30.40,P＜0.01).안광악성종류중58.3％적병조TIC형태표현위쾌승쾌강형,75.0％적DVP곡선형태표현위정부쌍상파형,안광량성종류중78.7％적TIC형태표현위쾌승만강형,74.5％적DVP곡선형태표현위정향파형,불동곡선형태적안수분포차이균유통계학의의(TIC:Z=-3.130,P=0.002;DVP:Z=-4.730,P=0.000).결론 초성조영검사현시불동조직병이학류형안광종류증강방식급곡선형태불동,초성조영유조우안광악성종류여안광량성종류적감별진단.
Background Orbital tumor has complex histological types and it is difficult for clinical differential diagnosis.Therefore, it is badly in need of a new diagnostic technology to distinguish its benign and malignancy.Objective This study aimed to analyze and compare the characteristics of contrast ultrasound image between benign and malignant orbital neoplasms and evaluate the diagnostic value of contrast ultrasound to orbital tumor.Methods The clinical data of 24 patients with malignant orbital neoplasms and 51 patients with benign orbital neoplasms were retrospectively analyzed in Taihe Hospital of Hubei University of Medicine from September 2010 to September 2013.Contrast ultrasound examination was carried out on all the patients using MyLab Twice color ultrasonic device under the informed consent.SonoVue solution of 2.0 ml was intravenously injected and then the state and dynamic graphs of orbital tumors were collected.According to the classification of enhanced levels and patterns,the imaging features of orbital neoplasms were evaluated, and time-intensity curve (TIC) and dynamic vascular pattern (DVP) curve were obtained with SonoLiver software.The general ultrasonic signs and contrast ultrasonic characteristics between benign and malignant neoplasms were compared.Results Hyper-enhanced lesions were found in 62.5％ (15/24) and 27.5％ (14/51) ,and iso-intensity lesions were found in 20.8％ (5/24) and 49.0％(25/51) in the malignant orbital neoplasm patients and benign ones, respectively, with a significant difference in enhanced types between them (x2 =26.40,P＜0.01).Based on the enhanced mode, heterogeneity enhancement lesions were found in 75.0％ (18/24) and 25.5％ (13/51), and hemogeneity enhancement lesions were seen in 25.0％(6/24) and 47.1％ (24/51) in the malignant orbital neoplasm patients and benign ones, respectively, showing a significant differnee between them (x2 =30.40, P ＜ 0.01).The 58.3％ patients showed rapid rising and sharp descending TIC curves,and 75.0％ patients showed the biphasic wave DVP curves in the malignant lesions;while in the benign lesions,the TIC curves of 78.7％ patients were quick lift and slow dessend, and the DVP curves of 74.5 ％patients appeared to be positive phasic wave.These curve features were significantly different between the malignant lesions and benign ones (TIC:Z=-3.130,P=0.002;DVP:Z =-4.730,P =0.000).Conclusions Contrastultrasound examination shows that different tissue-derived orbital neoplasms have varied enhanced modes and types.Contrast-ultrasound examination is helpful for the differential diagnosis of orbital neoplasms.
