Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
Graefes Arch Clin Exp Ophthalmol. 2023 Oct;261(10):2987-2996. doi: 10.1007/s00417-023-06068-3. Epub 2023 May 6.
To compare the diagnostic value of ultrasonic elastosonography (UE) and contrast-enhanced ultrasonography (CEUS) for benign and malignant intraocular tumors.
This retrospective study enrolled patients with intraocular tumors at Beijing Tongren Hospital, Capital Medical University (August 2016 to January 2020). The strain rate ratio (strain rate of tumor tissue divided by strain rate of surrounding normal tissue) was measured by UE. CEUS was performed using SonoVue® contrast agent. The performance of each method at differentiating benign from malignant intraocular tumors was evaluated by receiver operating characteristic curve analysis.
The analysis included 147 eyes in 145 patients (45.6 ± 13.4 years-old; 66 males): 117 patients (119 eyes) with malignant tumors and 28 patients (28 eyes) with benign tumors. At an optimal cutoff of 22.67 for the strain rate ratio, UE distinguished benign from malignant tumors with a sensitivity of 86.6% and a specificity of 96.4%. CEUS showed that 117 eyes with malignant tumors had a fast-in, fast-out time-intensity curve, and only two eyes with malignant tumors had a fast-in, slow-out curve, while all 28 eyes with benign tumors had a fast-in, slow-out curve. CEUS differentiated benign from malignant tumors with a sensitivity of 98.3% and a specificity of 100%. The diagnostic results differed significantly between the two methods (P = 0.004, McNemar test). The diagnostic performances of the two tests were moderately consistent (κ = 0.657, P < 0.001).
Both CEUS and UE have good diagnostic value in the differentiation of benign intraocular tumors from malignant intraocular tumors.
比较超声弹性成像(UE)和超声造影(CEUS)对眼内良恶性肿瘤的诊断价值。
本回顾性研究纳入了首都医科大学附属北京同仁医院(2016 年 8 月至 2020 年 1 月)的眼内肿瘤患者。通过 UE 测量应变率比值(肿瘤组织的应变率与周围正常组织的应变率之比)。采用 SonoVue®造影剂行 CEUS。通过受试者工作特征曲线分析评估每种方法在区分眼内良恶性肿瘤中的性能。
分析纳入了 145 例患者的 147 只眼(45.6±13.4 岁;男性 66 例):117 例(119 只眼)恶性肿瘤患者和 28 例(28 只眼)良性肿瘤患者。当应变率比值的最佳截断值为 22.67 时,UE 区分良恶性肿瘤的敏感度为 86.6%,特异度为 96.4%。CEUS 显示,117 只恶性肿瘤眼的时间-强度曲线为快进快出型,仅有 2 只恶性肿瘤眼的时间-强度曲线为快进慢出型,而 28 只良性肿瘤眼均为快进慢出型。CEUS 区分良恶性肿瘤的敏感度为 98.3%,特异度为 100%。两种方法的诊断结果差异有统计学意义(P=0.004,McNemar 检验)。两种检查的诊断性能具有中等一致性(κ=0.657,P<0.001)。
CEUS 和 UE 对眼内良恶性肿瘤的鉴别均具有良好的诊断价值。