Müller-Miny H, Pötter R, Clemens S, Knocke T H
Institut für Klinische Radiologie, Westfälische Wilhelms-Universität Münster.
Rofo. 1991 Apr;154(4):425-9. doi: 10.1055/s-2008-1033161.
193 patients with the ophthalmic diagnosis of a primary choroidal melanoma were studied by computed tomography (CT) in relation to the ultrasound (US) prominence. The location and size as well as the density of the tumour and the vitreous body were measured. The tumour was observed most frequently in the fifth, sixth, and seventh decades of life, with a female preponderance in our series. There was a high correlation between CT and US in the average tumour thickness. But we measured a greater thickness in tumours with US prominence less than 3.5 mm and a smaller thickness in tumours with a US prominence greater than 6 mm. 79% of the melanomas could be distinguished by CT. Especially melanomas with an US prominence of less than 3 mm failed to be detected. The smallest tumour that could be differentiated by CT had a prominence of 2 mm, the largest missed had a prominence of 3.5 mm. In 75% of our contrast CT in patients with 2.5 and 3 mm prominence we could diagnose the tumour, in the noncontrast CT it was only possible in 34%. The enhancement of the vitreous body and the tumour were noted in all patients with contrast CT, the average density increased in the vitreous body for 22% and in the melanoma for 30%. Hence, it is essential to use intravenous contrast media in small choroidal melanomas.
对193例经眼科诊断为原发性脉络膜黑色素瘤的患者进行了计算机断层扫描（CT）研究，并与超声（US）突出度相关联。测量了肿瘤的位置、大小以及肿瘤和玻璃体的密度。该肿瘤在50、60和70岁年龄段最为常见，在我们的系列研究中女性占优势。CT和US在平均肿瘤厚度方面具有高度相关性。但我们发现，超声突出度小于3.5mm的肿瘤厚度测量值较大，而超声突出度大于6mm的肿瘤厚度测量值较小。79%的黑色素瘤可通过CT区分。特别是超声突出度小于3mm的黑色素瘤未能被检测到。CT能够区分的最小肿瘤突出度为2mm，漏诊的最大肿瘤突出度为3.5mm。在超声突出度为2.5mm和3mm的患者中，75%的增强CT能够诊断出肿瘤，而平扫CT仅为34%。所有增强CT患者均观察到玻璃体和肿瘤的强化，玻璃体平均密度增加22%，黑色素瘤平均密度增加30%。因此，对于小脉络膜黑色素瘤，使用静脉造影剂至关重要。
