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目的 探讨年龄相关性黄斑变性(AMD)患者的彩色多普勒血流成像(CDFI)超声影像特征。方法 应用CDFI超声诊断仪检测98例AMD患者,观察、分析其CDFI影像特征,并与脉络膜黑色素瘤、脉络膜转移癌、脉络膜黑色素细胞瘤、黄斑水肿等疾病相鉴别。结果 干性AMD患者的CDFI影像特征:多数患者经CDFI超声检测无特殊发现,部分患者CDFI影像中可见黄斑区球壁回声局限隆起,但隆起高度一般不超过1 5mm,病变内可见边界清晰的点状强回声,基底部血流信号较丰富。湿性AMD患者的CDFI影像特征:黄斑区呈现半球形或不规则形实性病变,边界清晰,但不规则,内回声均匀为中强回声,无脉络膜凹陷;病变的基底部可探及较丰富的血流信号,表面可探及点状、带状血流信号,病变内部无异常血流信号。应用CDFI诊断干性和湿性AMD患者,关键在于黄斑区病变的形态、边界、内部回声、玻璃体内有无同时合并玻璃体混浊(积血)等。依据AMD患者的CDFI影像特征和血流形态,可与脉络膜黑色素瘤、脉络膜转移癌、脉络膜黑色素细胞瘤、黄斑水肿等疾病相鉴别。结论 应用CDFI检测AMD患者的方法简便、诊断准确,值得临床推广应用。
Objective To investigate the color Doppler flow imaging (CDFI) features in patients with age-related macular degeneration (AMD). Methods Ninety-nine patients with AMD were examined by CDFI. The CDFI features were observed and analyzed. The features of CDFI were compared with those of choroidal melanoma, choroidal metastasis, choroidal melanocytoma and macular edema. Results The features of CDFI in patients with dry AMD: Most patients had no special findings by CDFI. Some of the patients showed macular echogenic wall uplift in CDFI images, but the height of uplift did not exceed 1 5 mm. Strong echogenic, basal part of the blood flow signal is more abundant. CDFI imaging features of wet AMD patients: macular area showed hemispherical or irregular solid lesions, the border is clear, but irregular, the echo is uniform and moderate echogenic, no choroidal depression; lesion base to explore and more abundant Blood flow signal, the surface can be detected and punctate, ribbon blood flow signals, no abnormal blood flow within the lesion signal. CDFI diagnosis of patients with dry and wet AMD, the key lies in the morphology of macular degeneration, the boundary, internal echo, the vitreous with or without vitreous opacity (hemorrhage) and so on. According to CDFI imaging features of AMD patients and blood flow morphology, with choroidal melanoma, choroidal metastasis, choroidal melanocytoma, macular edema and other diseases phase identification. Conclusion The method of detecting CDFI in patients with AMD is simple and accurate, which is worthy of clinical application.