Lemke A J, Hosten N, Bornfeld N, Bechrakis N E, Frenzel D, Richter M, Felix R
Strahlenklinik und Poliklinik, Universitätsklinikum Charité, Medizinische Fakultät, Humboldt-Universität, Berlin.
Rofo. 1998 Nov;169(5):471-8. doi: 10.1055/s-2007-1015322.
Choroidal melanomas usually present a characteristic appearance in MRI. Differing characteristics can cause problems in differential diagnosis between melanomas and other masses in the globe. The purpose of this study was to evaluate the appearance of choroidal melanomas with MRI in a large consecutive patient group.
In a prospective study, 200 patients with choroidal melanomas were investigated with MRI using a 1.5 T scanner and a 5 cm surface coil. Both quantitative and qualitative evaluation of the resulting images was performed.
78.5% of the melanomas presented with homogeneous signal intensities within the tumor due to a homogeneous pigmentation whereas 21.5% of the melanomas demonstrated a mixed pigmentation. Signal intensities of the homogeneous melanomas in the plain T1-WI were moderately or markedly hyperintense compared to the vitreous in 29.3% and moderately or markedly hypointense in the T2-WI in 37.1%. An accompanying retinal detachment was found in 65.5% and an extraocular growth in 7.0%.
In 10% to 37% we observed the typical well known MR appearance, including homogeneous high signal in the T1-WI and low signals in the T2-WI. For further differentiation, morphological criteria (e.g. shape, size, and position) were used, which are also discussed.
脉络膜黑色素瘤在磁共振成像(MRI)中通常呈现出特征性表现。不同的特征可能会在黑色素瘤与眼球内其他肿物的鉴别诊断中引发问题。本研究的目的是在一个连续纳入的大型患者群体中,评估脉络膜黑色素瘤的MRI表现。
在一项前瞻性研究中,使用1.5T扫描仪和5cm表面线圈对200例脉络膜黑色素瘤患者进行了MRI检查。对所得图像进行了定量和定性评估。
78.5%的黑色素瘤因色素沉着均匀而在肿瘤内呈现均匀信号强度,而21.5%的黑色素瘤表现为混合色素沉着。在平扫T1加权成像(T1-WI)中,均匀性黑色素瘤的信号强度与玻璃体相比,29.3%为中度或明显高信号,在T2加权成像(T2-WI)中37.1%为中度或明显低信号。发现伴有视网膜脱离的占65.5%,眼外生长的占7.0%。
我们观察到10%至37%的病例具有典型的、众所周知的MRI表现,包括T1-WI中均匀高信号和T2-WI中低信号。为了进一步鉴别,使用了形态学标准(如形状、大小和位置),并对其进行了讨论。