Maberly D A, Pavlin C J, McGowan H D, Foster F S, Simpson E R
Department of Ophthalmology, Ontario Cancer Institute, Princess Margaret Hospital, University of Toronto, Canada.
Am J Ophthalmol. 1997 Apr;123(4):506-14. doi: 10.1016/s0002-9394(14)70176-x.
To correlate ultrasound biomicroscopic features of the anterior aspect of peripheral choroidal melanoma with respect to histopathology.
We examined 17 eyes of 17 patients who had clinically diagnosed peripheral choroidal melanomas that approached the ora serrata or extended into the ciliary body and who had been assessed with ultrasound biomicroscopy before enucleation. Comparisons were made between anterior tumor margins imaged by ultrasound biomicroscopy and histopathologic specimens. Anatomic features noted on ultrasound biomicroscopy before enucleation were correlated with enucleation specimens, including supraciliary effusion, rotation of the ciliary body, angle involvement, and internal reflectivity patterns. Anterior tumor margin position was determined with reference to the scleral spur.
Mean distances from the anterior tumor margin to the scleral spur were 1.47 mm on ultrasound biomicroscopy and 1.65 mm on pathologic examination. This difference was not statistically significant (P = .325). Tumor features evident on ultrasound biomicroscopy were also seen on pathologic examination: supraciliary choroidal effusions in seven of seven, ciliary body rotation in seven of eight, and angle involvement in seven of eight. All tumors were mixed-cell melanomas, and 12 of 17 (70%) demonstrated homogeneous ultrasound biomicroscopic internal reflectivity. Irregular internal reflectivity was seen in five of 17 tumors (29%) and was related to prominent internal vascularity on pathology in three of five.
Ultrasound biomicroscopy is an accurate imaging technique for the in vivo assessment of anterior tumor margins of peripheral choroidal melanomas and can provide detailed imaging of the tumor's interface with the ciliary body.
将周边脉络膜黑色素瘤前部的超声生物显微镜特征与组织病理学进行关联。
我们检查了17例患者的17只眼睛，这些患者临床诊断为周边脉络膜黑色素瘤，肿瘤接近锯齿缘或延伸至睫状体，且在眼球摘除术前接受了超声生物显微镜检查。对超声生物显微镜成像的肿瘤前部边缘与组织病理学标本进行了比较。将眼球摘除术前超声生物显微镜检查发现的解剖学特征与眼球摘除标本进行关联，包括睫状体上腔积液、睫状体旋转、房角受累情况以及内部反射模式。根据巩膜突确定肿瘤前部边缘位置。
超声生物显微镜检查显示肿瘤前部边缘到巩膜突的平均距离为1.47mm，病理检查为1.65mm。这种差异无统计学意义（P = 0.325）。超声生物显微镜检查发现的肿瘤特征在病理检查中也可见：7例中有7例存在睫状体上腔脉络膜积液，8例中有7例出现睫状体旋转，8例中有7例房角受累。所有肿瘤均为混合细胞型黑色素瘤，17例中有12例（70%）超声生物显微镜检查显示内部反射均匀。17例肿瘤中有5例（29%）出现不规则内部反射，其中5例中有3例与病理上明显的内部血管形成有关。
超声生物显微镜检查是一种准确的成像技术，可用于在体评估周边脉络膜黑色素瘤的肿瘤前部边缘，并能提供肿瘤与睫状体界面的详细成像。
