目的：分析脉络膜转移癌和脉络膜血管瘤的常规超声和超声造影(CEUS)特点，探讨常规超声联合CEUS在脉络膜转移癌和脉络膜血管瘤鉴别诊断中的临床应用价值。

方法：回顾性分析2010-05/2016-01于沈阳市第四人民医院诊治的脉络膜转移癌患者17例17眼和脉络膜血管瘤患者35例35眼的常规超声和CEUS资料，常规超声观察肿瘤的二维和彩色多普勒特点，CEUS观察肿瘤的造影剂灌注强度和变化情况，并分析CEUS动态资料获得TI曲线和CEUS参数。

结果：常规超声检查显示，脉络膜转移癌较脉络膜血管瘤回声偏低、欠均匀，隆起度较均匀一致，表面呈波浪状，其诊断脉络膜转移癌、脉络膜血管瘤的正确率分别为59%(10/17)、68%(24/35)。CEUS检查显示，脉络膜转移癌TI曲线类型多呈快进快出模式(14/17)，脉络膜血管瘤TI曲线类型多呈快进慢出模式(31/35)； 脉络膜转移癌峰值强度(IMAX)、上升时间(RT)均低于脉络膜血管瘤(P<0.05)。常规超声联合CEUS诊断脉络膜转移癌、脉络膜血管瘤的正确率分别为82%(14/17)、88%(31/35)。

结论：常规超声联合CEUS可为脉络膜转移癌和脉络膜血管瘤的鉴别诊断提供较为可靠的影像学依据，有助于两种肿瘤的早期定性诊断。

METHODS: The conventional ultrasound and CEUS data of 17 cases(17 eyes)with choroidal metastatic carcinoma and 35 cases(35 eyes)with choroidal hemangioma treated in the Fourth People's Hospital of Shenyang from May 2010 to January 2016 was retrospectively analyzed. The two-dimensional color ultrasound and the color Doppler characteristics of the tumors were observed by conventional ultrasound. CEUS was used to observe the contrast agent perfusion intensity and changes of tumors, and CEUS dynamic data was analyzed to obtain TI curves and CEUS parameters.

RESULTS: Conventional ultrasound examination showed that choroidal metastatic carcinoma had lower echo, less uniform, more uniform uplift, and wavy surface compared with choroidal hemangioma. The accuracy of diagnosis of choroidal metastatic carcinoma and choroidal hemangioma were 59%(10/17)and 68%(24/35)respectively. CEUS examination showed that the TI curve types of choroidal metastatic carcinoma were mostly in fast-in and fast-out mode(14/17), while the TI curve types of choroidal hemangioma were mostly in fast-in and slow-out mode(31/35). Both maximum intensity(IMAX)and rise time(RT)of choroid metastatic carcinoma were lower than those of choroid hemangioma(P<0.05). The accuracy of conventional ultrasound combined with CEUS in the diagnosis of choroidal metastatic carcinoma and choroidal hemangioma was 82%(14/17)and 88%(31/35)respectively.

CONCLUSION: Conventional ultrasound combined with CEUS can provide a relatively reliable imaging basis for the differential diagnosis of choroidal metastatic carcinoma and choroidal hemangioma, which is helpful for the early qualitative diagnosis of the two tumors.