Cui R, Yang W L, Chen W, Li D J, Wang Z Y, Zhao Q, Li Y F, Shen L, Liu Q, Wei W B, Xian J F
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing 100730, China.
Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China.
Zhonghua Yan Ke Za Zhi. 2020 Sep 11;56(9):676-680. doi: 10.3760/cma.j.cn112142-20200308-00160.
To explore the role of the scoring and strain ratio methods of ultrasonic elastography in the differential diagnosis of choroidal melanoma and choroidal hemangioma. A cross-sectional study. Twenty-five patients (25 eyes) with choroidal melanoma treated in the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University from July to October 2016 were included in this study. There were 13 males and 12 females, with an average age of (48±12) years old. Twenty-five patients (25 eyes) with choroidal hemangioma treated in the same period were selected for differential diagnosis, including 12 males and 13 females, with an average age of (37±13) years. The lesions were examined by ultrasound elastography and scored, and the strain ratio of the tumor to the orbital tissue was measured. Two independent sample test was used to compare the difference in the elasticity score and strain ratio between choroidal melanoma and choroidal hemangioma. The sensitivity, specificity and area under the receiver operating characteristic (ROC) curve were calculated to analyze the value of the two methods in the differential diagnosis of choroidal melanoma and choroidal hemangioma. The elastography score of choroidal melanoma was (3.48±0.77) points, including 2 points in 3 cases, 3 points in 8 cases, 4 points in 13 cases, and 5 points in 1 case. The elastography score of hemangioma was (2.28±0.46) points, including 2 points in 18 cases and 3 points in 7 cases. The difference in the elasticity score between patients with the two kinds of tumors was statistically significant (=6.694, <0.01). The strain ratio was 42.97±15.83 and 12.21±9.24 in the patients with choroidal melanoma and choroidal hemangioma, respectively, and the difference was statistically significant (=8.392, <0.01). Using 3 points as the diagnostic critical point of the elastography score, the sensitivity was 88.0%, the specificity was 72.0%, and the area under the ROC curve was 0.80 (95% cofidence interval: 0.663 to 0.900, <0.01). Using 21.67 as the diagnostic critical point of the strain ratio, the sensitivity was 92.0%, the specificity was 92.0%, and the area under the ROC curve was 0.92 (95% cofidence interval: 0.808 to 0.978, <0.01). Ultrasound elastography plays a role in the differential diagnosis of choroidal melanoma and choroidal hemangioma. The differential diagnostic value of the strain ratio method is higher than the scoring method. .
探讨超声弹性成像评分法及应变率法在脉络膜黑色素瘤与脉络膜血管瘤鉴别诊断中的作用。一项横断面研究。纳入2016年7月至10月在首都医科大学附属北京同仁医院眼科治疗的25例(25只眼)脉络膜黑色素瘤患者。其中男性13例,女性12例,平均年龄(48±12)岁。同期选取25例(25只眼)脉络膜血管瘤患者进行鉴别诊断,其中男性12例,女性13例,平均年龄(37±13)岁。采用超声弹性成像对病变进行检查并评分,测量肿瘤与眶周组织的应变率。采用两独立样本检验比较脉络膜黑色素瘤与脉络膜血管瘤弹性评分及应变率的差异。计算受试者操作特征(ROC)曲线下面积、敏感度及特异度,分析两种方法在脉络膜黑色素瘤与脉络膜血管瘤鉴别诊断中的价值。脉络膜黑色素瘤弹性成像评分为(3.48±0.77)分,其中2分3例,3分8例,4分13例,5分1例。血管瘤弹性成像评分为(2.28±0.46)分,其中2分18例,3分7例。两种肿瘤患者弹性评分差异有统计学意义(=6.694,<0.01)。脉络膜黑色素瘤患者应变率为42.97±15.83,脉络膜血管瘤患者应变率为12.21±9.24,差异有统计学意义(=8.392,<0.01)。以弹性成像评分3分为诊断临界点,敏感度为88.0%,特异度为72.0%,ROC曲线下面积为0.80(95%可信区间:0.663至0.900,<0.01)。以应变率21.67为诊断临界点,敏感度为92.0%,特异度为92.0%,ROC曲线下面积为0.92(95%可信区间:0.808至0.978,<0.01)。超声弹性成像在脉络膜黑色素瘤与脉络膜血管瘤的鉴别诊断中具有一定作用,应变率法的鉴别诊断价值高于评分法。