Panova I E, Samkovich E V, Melikhova M V, Grigoryeva N N
Saint Petersburg branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», St. Petersburg, Russia.
Saint Petersburg Consultative and Diagnostic Center No.1, St. Petersburg, Russia.
Vestn Oftalmol. 2020;136(5):5-13. doi: 10.17116/oftalma20201360515.
To study the use of ultrasound color Doppler imaging and indocyanine green (ICG) angiography for identification of malignant vasculature of choroidal tumors.
The study included 46 patients (46 eyes) with tumors of the choroid: 19 men and 26 women aged 22 to 89 years, average age 53.2±17.1 years. All patients underwent indocyanine green angiography and Doppler ultrasound imaging. At the time of examination, thickness of the tumors ranged from 1.1 mm to 3.0 mm, and the base diameter from 4.0 mm to 13.0 mm. Choroidal melanoma was diagnosed in 27 patients, choroidal nevus in 10, choroidal hemangioma in 5, and choroidal metastasis in 4 patients.
The results of indocyanine green angiography demonstrate that the pathological malignant vasculature was determined: nevi was diagnosed in 7 out of 10 patients, choroidal melanoma in 16 out of 27, metastasis in 2 out of 4, and hemangioma in none of the 5 patients. Pathological malignant vasculature was determined in most patients with choroidal melanoma (77.8%), in all patients with choroidal hemangioma and in 3 patients with choroidal metastases. Ultrasound imaging revealed malignant vasculature in 15 of 27 (56%) patients with choroidal melanoma, it could be identified in all patients with hemangioma in 2 patients and with choroidal metastases, and in none patients with choroidal nevi.
Indocyanine green angiography helps verify malignant vasculature in 77.8% of patients with small and medium sized choroidal melanomas. Angioarchitecture of choroidal tumors visualized with indocyanine green angiography is characterized by variability of patterns, which should be taken into account in the differential diagnosis of various pathological diseases.
研究超声彩色多普勒成像和吲哚菁绿（ICG）血管造影在识别脉络膜肿瘤恶性血管方面的应用。
该研究纳入了46例（46只眼）脉络膜肿瘤患者，其中男性19例，女性26例，年龄22至89岁，平均年龄53.2±17.1岁。所有患者均接受了吲哚菁绿血管造影和多普勒超声成像检查。检查时，肿瘤厚度为1.1毫米至3.0毫米，基底直径为4.0毫米至13.0毫米。27例患者被诊断为脉络膜黑色素瘤，10例为脉络膜痣，5例为脉络膜血管瘤，4例为脉络膜转移瘤。
吲哚菁绿血管造影结果显示确定了病理性恶性血管：10例患者中有7例诊断为痣，27例中有16例为脉络膜黑色素瘤，4例中有2例为转移瘤，5例血管瘤患者均未发现。大多数脉络膜黑色素瘤患者（77.8%）、所有脉络膜血管瘤患者以及3例脉络膜转移瘤患者中确定了病理性恶性血管。超声成像显示，27例脉络膜黑色素瘤患者中有15例（56%）存在恶性血管，所有血管瘤患者中有2例以及脉络膜转移瘤患者中可识别出恶性血管，而脉络膜痣患者均未发现。
吲哚菁绿血管造影有助于在77.8%的中小型脉络膜黑色素瘤患者中验证恶性血管。吲哚菁绿血管造影显示的脉络膜肿瘤血管结构具有模式变异性，在各种病理性疾病的鉴别诊断中应予以考虑。
