Department of Radiology, 26686Prince of Songkla University, Thailand.
Neuroradiol J. 2021 Apr;34(2):113-119. doi: 10.1177/1971400920973407. Epub 2020 Dec 2.
Comparing the signal intensity (SI) of an ocular mass to that of the vitreous body has been suggested. Most ocular lesions show a hyper-intense signal compared to the vitreous body on T1-weighted (T1w) images, and malignant melanomas have been almost always determined as 'cannot be excluded' in reports.
This study aimed to determine the accuracy of magnetic resonance imaging (MRI) in the diagnosis of uveal melanoma by using normal white matter as reference tissue for SI evaluation on T1w images and vitreous body on T2w compared to the conventional method using the vitreous body as a reference on both T1w and T2w images.
The MRIs of 43 patients (between August 2006 and July 2018) sent to rule out uveal melanoma were blindly reviewed by two radiologists. By using white matter as a reference for SI evaluation on T1w images and vitreous body as a reference on T2w images, uveal melanomas were suggested by hyper-intense signal on T1w and hypo-intense signal on T2w with homogeneous enhancement. The accuracy of diagnosis of uveal melanoma using white matter as a reference on T1w was compared to the conventional method using the vitreous body as a reference on both T1w and T2w images.
The diagnosis of uveal melanoma using white matter as a reference gave a sensitivity of 92.31% (95% confidence interval (CI) 63.97-99.81) and specificity of 100.0% (95% CI 88.43-100.0). By using the vitreous body as a reference, sensitivity as high as 100.0% (95% CI 100.0-100.0) was obtained, but specificity was low at 53.33% (95% CI 34.33-71.66).
White matter is a good reference for the diagnosis of uveal melanoma, with high sensitivity and much higher specificity than conventional methods using the vitreous body as a reference.
有人提出比较眼球肿块的信号强度（SI）与玻璃体的信号强度。大多数眼部病变在 T1 加权（T1w）图像上显示为高于玻璃体的高信号，而恶性黑色素瘤在报告中几乎总是被确定为“不能排除”。
本研究旨在通过使用正常的白质作为 T1w 图像上 SI 评估的参考组织，以及玻璃体作为 T2w 图像上的参考组织，来确定磁共振成像（MRI）在诊断脉络膜黑色素瘤中的准确性，与传统的使用玻璃体作为 T1w 和 T2w 图像上的参考组织的方法进行比较。
回顾性分析了 2006 年 8 月至 2018 年 7 月期间 43 例（43 例）因怀疑脉络膜黑色素瘤而进行的 MRI 检查。通过使用白质作为 T1w 图像上 SI 评估的参考组织，以及玻璃体作为 T2w 图像上的参考组织，如果 T1w 上显示高信号，T2w 上显示低信号，且均匀增强，则提示为脉络膜黑色素瘤。将使用白质作为 T1w 参考的诊断脉络膜黑色素瘤的准确性与传统的使用玻璃体作为 T1w 和 T2w 图像上的参考的方法进行比较。
使用白质作为参考的脉络膜黑色素瘤诊断的敏感性为 92.31%（95%置信区间（CI）63.97-99.81），特异性为 100.0%（95% CI 88.43-100.0）。使用玻璃体作为参考，可获得高达 100.0%（95% CI 100.0-100.0）的敏感性，但特异性较低，为 53.33%（95% CI 34.33-71.66）。
白质是诊断脉络膜黑色素瘤的良好参考，具有较高的敏感性和比传统的使用玻璃体作为参考的方法更高的特异性。
