The Analysis Of Color Doppler Imaging In 1495 Cases Of Ocular Tumors

PurposeColor Doppler ultrasound is one of the most commonly used tools for ocular tumors. It could not only localize the lesions, but also show the internal echo and hemodynamic parameters of tumors, which is helpful in the diagnosis and treatment for orbital tumors. The aim of this study is to investigate the application of color Doppler ultrasound in the diagnosis of orbital diseases, on the basis of large amount of cases review. Color Doppler ultrasound imaging of various ocular tumors from Ophthalmology Department of the Second Hospital of Tianjin Medical University was retrospectively analyzed, the Doppler imaging features from different diseases were compared, and the value of color Doppler flow imaging in the diagnosis and differential diagnosis of ocular diseases was summarized.MethodsColor Doppler ultrasound imaging of 1495 cases of ocular tumors, diagnosed by imaging or pathology from 1996 to 2009 (13 years) were retrospectively analyzed. According to the classification, such as orbital cyst, vascular tumors, neuronal tumors, non-specific inflammation, lacrimal gland tumor, vascular malformation, intraocular tumors, different parameters as the lesion location, shape, border, internal echo, relationship with surrounding tissue, volume, location, shape, and flow parameters of blood flow were summarized. The character of color Doppler flow imaging;of different kinds of diseases was reviewed and compared. In combination with clinical feathers and other imaging finds, the diagnosis and differential diagnosis from all the above diseases were discussed and analyzed. Results1. No blood flow was found within orbital cystic lesions;2. Rich blood flow (lamellar diffused) was found within capillary hemangioma, which has the most blood flow signals among all the vascular tumors. And also the treatment effects of medication could be evaluated from the internal blood echo signals changing.3. Almost no blood flow was found within most cases of cavernous hemangioma, while some point-shape blood signals could be found in some cases as well. The blood spectrum included arteries spectrum and veins spectrum. And RI value was the highest among the vascular tumors.4. Meningiomas were irregular shape with optic nerve enlargement and media or low level of echo, and internal echo was unevenly distributed with rich internal blood signals. Cavernous hemangiomas were oval with clear boundary, the internal echo was in media level with uniform distribution with less or no blood flow signals. A small circular echo-free zone could be found in nerve sheath tumor with almost no blood flow. In this study, significant difference was found in these blood flow parameters including PSV and RI among these three kinds of tumors, which could be used for the differentiations.5. Lacrimal gland pleomorphic adenoma, adenoid cystic carcinoma, inflammatory pseudotumor, and non-Hodgkin lymphoma could all occur in the lacrimal gland, so differentiations were often needed. Less or none blood flow was found in CDI in lacrimal pleomorphic adenomas, while rich blood flow was in inflammatory pseudotumors. Sonogram showed that pleomorphic adenomas of lacrimal gland were round or oval shape, and internal echo was weak, while inflammatory pseudotumors were irregular with weak internal echo. Internal echo from Non-Hodgkin's lymphoma was relatively lowr with rich internal blood flow, which could be used for differentiation to lacrimal mixed tumors. The difference between lacrimal gland adenoid cystic carcinoma and pleomorphic adenoma was the CDI value, which was with rich internal blood flow in the former. Significant difference was found for PSV and RI value among the perimeters in these four kinds of tumors.6. Ultrasonography of choroidal melanoma usually showed spherical or hemispherical protuberant lesions, while choroidal metastases and choroidal hemangioma were flat elevated lesions. It was very difficult to differentiate these three kinds of tumors from blood flow features. This study compared the values of PSV and RI among choroidal melanoma, metastases and hemangioma, and no significance was found (P>0.05).ConclusionColor Doppler ultrasound is a simple, non-invasive, and dynamic tool, indicating blood flow distribution and pathological characteristics of the spectrum, and the blood supply of the tumors, which is important for the diagnosis and treatment for the ocular tumors.