Orbit Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Via S. Pansini 5, 80133, Naples, Italy.
Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
J Ultrasound. 2021 Mar;24(1):35-40. doi: 10.1007/s40477-020-00443-0. Epub 2020 Mar 12.
The aim of this study is to assess the value of ultrasound in the differential diagnosis of orbital lesions.
One hundred and thirty-eight patients with clinical features of an orbital mass were examined by orbital ultrasound prior to undergoing surgery, from January 2000 to January 2017. All patients underwent excisional or incisional orbital biopsy. The results of orbital ultrasonography were compared with the final histological diagnosis.
Orbital lesions were localized by ultrasonography in 133/138 cases (96.4%); the false-negative rate of orbital echography was 3.6% (5/138). The nature of the orbital lesions was correctly determined by ultrasonography in 54.3% of the cases (75/138) preoperatively (true positives). In 58/138 (42%) patients, there was no correspondence between the ultrasound diagnosis and the histological diagnosis (false positives). The sensitivity of orbital ultrasonography for the detection of an orbital mass was 93.75% (CI 87.87-99.63%), while the specificity yielded no meaningful result (CI 0.00-60.24%). Moreover, the specificity of orbital ultrasonography to identify a malignant tumor falls within a CI of 0-62.72%.
Orbital ultrasonography is a rapid and noninvasive test that is highly sensitive in displaying an orbital mass; however, the specificity in the differential diagnosis of orbital lesions is not meaningful, particularly if malignancy is suspected. The assessment of orbital diseases requires multiple diagnostic approaches to balance the strengths and weaknesses of each method.
本研究旨在评估超声在眼眶病变鉴别诊断中的价值。
2000 年 1 月至 2017 年 1 月，对 138 例具有眼眶肿块临床特征的患者进行眼眶超声检查，所有患者均行眼眶切除或切开活检。将眼眶超声检查结果与最终组织学诊断进行比较。
眼眶超声在 133/138 例（96.4%）患者中定位眼眶病变；眼眶超声的假阴性率为 3.6%（5/138）。术前眼眶超声正确判断眼眶病变性质的准确率为 54.3%（75/138）（真阳性）。在 58/138（42%）例患者中，超声诊断与组织学诊断无对应关系（假阳性）。眼眶超声检测眼眶肿块的敏感性为 93.75%（CI 87.87-99.63%），特异性无意义（CI 0.00-60.24%）。此外，眼眶超声鉴别眼眶恶性肿瘤的特异性在 CI 为 0-62.72%。
眼眶超声是一种快速、非侵入性的检查方法，在显示眼眶肿块方面高度敏感；然而，在眼眶病变的鉴别诊断中，特异性没有意义，特别是怀疑恶性肿瘤时。评估眼眶疾病需要多种诊断方法，以平衡每种方法的优缺点。
