[Characteristics of choroidal melanoma in contrast-enhanced ultrasonography]

To investigate the characteristics of choroidal melanoma in contrast-enhanced ultrasonography.

Case-control study.From October 2007 to December 2008, 21 choroidal melanoma patients (21 eyes) were treated in Beijing Tongren Hospital,including 13 males and 8 females with average age at 57 years (ranged from 18 to 76 years).Fourteen cases (14 eyes) of choroidal hemangioma treated during the same period, including 9 males and 5 females, with average age at 51 years(ranged from 24 to 71 years) were selected for the comparison.All patients were examined with contrast-enhance ultrasound, the contrast agent (sulfur hexafluoride) was injected into elbow vein,continuous recording of contrast agent in the lesions was conducted from filling to subside stages. Sonoliver software was used to analyze the imaging process.Logistic regression was used to compare the data collected from choroidal melanoma and hemangioma to develop a differential diagnosis equation for the diagnosis of choroidal melanoma.

Contrast-enhanced ultrasonography in choroidal melanoma showed the following characteristics: the lesions were completely filled with the contrast reagent,the typical filling process began from the peripheral area to the center,filling defects were found in some cases,filling time in the melanoma was later than that in the normal tissues and faded early than that in the normal tissues. Quantitative analysis in choroidal melanoma lesions showed that the time to peak of contrast material [(22.80 ± 9.85)s] was less than that in the control group [(29.57 ± 24.76)s], maximum intensity [(191.31 ± 146.90)%] was greater than that in the control group [(100.00 ± 0.00)%]; rising time [(18.52 ± 7.09)s] was less than that in the control group [(26.45 ± 21.83)s] and mean transit time [(63.56 ± 26.04)s] was less than that in the control group [(149.87 ± 182.68)s]. The differences of maximum intensity and mean transit time between the melanoma and the controls were statistically significant (t = -2.848,2.197; P < 0.01). Logistic regression equation using the maximum intensity and mean transit time parameters could distinguish choroidal melanoma and hemangioma with a sensitivity at 90.5% (19/21) and specificity at 12/14.

Contrast-enhanced ultrasonography is a new method for the diagnosis of malignant tumors in the eye. Contrast-enhanced ultrasonography combining with quantitative analysis can be helpful for the diagnosis and different diagnosis of choroidal melanoma.