METHODS: The clinical data of 44 patients collected from May 2012 to December 2019 in Chinese PLA General Hospital was retrospectively studied. All of these patients underwent PIB of the eye, because it was difficult to diagnose by routine ocular fundus examination, conventional ultrasound or/and ultrasonic biomicroscope (UBM) due to opacity of refractive media, pupillary occlusion, large involvement or special location of the lesion. The imaging features of difficult cases in PIB were analyzed. The diagnosis accuracy rating of PIB were evaluated and contrasted with conventional ultrasound or UBM by the standard of intraoperative diagnosis or/and pathological results.
RESULTS: According to intraoperative diagnosis or pathological results as gold standard, among the 44 cases, there were 19 cases missed diagnosis, misdiagnosed or difficult-to-diagnose by conventional ultrasound or UBM, including 4 cases of long-standing RD difficult to diagnose, 4 cases misdiagnosed, and 11 cases incompletely observed or miss diagnosed. The diagnostic accuracy rate of PIB and conventional ultrasound or UBM were 100% (44/44) and 56.82% (25/44), and the sensitivity of them were 100% and 56.82%. All the patients underwent PIB and were diagnosed as RD (15 cases), retinal and choroidal detachment (4 cases), subchoroidal hematocele (1 case), vitreous opacity and/or organic membrane formation (4 cases), PHPV (12 cases), iris and/or ciliary body tumors (3 cases), and choroidal tumors (6 cases). According to the intraoperative diagnosis or pathological results, the diagnostic coincidence rate of PIB was 100%, which was significantly higher than conventional ultrasound and UBM.
CONCLUSIONS: PIB can help to accurately diagnose complex RD, PHPV, and intraocular masses with special location or/and excessive size. It has important diagnostic value for patients with equivocal findings at conventional ultrasound examination.
方法:回顾性分析2012年5月至2019年12月解放军总医院收治的44例患者的临床资料。所有这些患者都接受了眼睛的PIB,因为常规眼底检查很难诊断,由于折射介质的不透明性,常规超声或/和超声生物显微镜(UBM),瞳孔闭塞,大面积受累或病变的特殊位置。分析PIB疑难病例的影像学特征。根据术中诊断或/和病理结果的标准,评估PIB的诊断准确性并与常规超声或UBM进行对比。
结果:以术中诊断或病理结果为金标准,在44个案例中,有19例漏诊,常规超声或UBM误诊或难以诊断,包括4例难以诊断的长期RD,4例误诊,11例观察不完全或漏诊。PIB和常规超声或UBM的诊断准确率分别为100%(44/44)和56.82%(25/44),灵敏度分别为100%和56.82%。所有患者均行PIB,诊断为RD(15例),视网膜和脉络膜脱离(4例),脉络膜下血肿(1例),玻璃体混浊和/或有机膜形成(4例),PHPV(12例),虹膜和/或睫状体肿瘤(3例),脉络膜肿瘤(6例)。根据术中诊断或病理结果,PIB的诊断符合率为100%,明显高于常规超声和UBM。
结论:PIB可以帮助准确诊断复杂的RD,PHPV,和特殊位置或/和过大的眼内肿块。对于常规超声检查结果不明确的患者具有重要的诊断价值。