Echographic examination with new generation contrast agent of choroidal malignant melanomas.
OBJECTIVE
To determine the efficacy of echography with new generation contrast agents in visualizing vascularization of choroidal malignant melanomas.


METHODS
An echographic contrast medium consisting of phospholipidic microbubbles filled with sulphur hexafluoride (Sonovue) was used to visualize microcirculation in 25 cases of choroidal lesions already diagnosed with standardized echography (21 choroidal malignant melanomas, four disciform lesions).


RESULTS
In untreated malignant melanomas contrast agent echography revealed the presence of a dense microcirculation inside the mass. In one case vitreal seeding of the contrast agent was detectable before enucleation and histological examination revealed the presence of tumoral cells. In 12 cases treated with transpupillary thermotherapy, contrast agent echographic evaluation showed heavy regression of microcirculation after 1 week, confirmed in one case by histology, and a reduction of 70-80% in dimensions after 6 months (which appeared to have stabilized at subsequent examinations). In four cases treated with proton beam brachytherapy 2 years prior to our examination, contrast agent echography showed the absence of a microvascular network and the presence of large vessels and blood lakes. In four cases of disciform lesion, deep and superficial retina-associated vascularization was observed, with a weak spread of contrast agent inside the lesion.


CONCLUSIONS
Live representation with good resolution of choroidal malignant melanoma microcirculation was obtained.
Forte
R
R
Department of Ophthalmology, University Federico II, Naples, Italy.
Cennamo
G
G
Staibano
S
S
De Rosa
G
G
D000328:Adult; D000368:Aged; D001918:Brachytherapy; D002830:Choroid Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000628:therapy; D003287:Contrast Media; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008545:Melanoma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000628:therapy; D008833:Microcirculation; D008875:Middle Aged; D009366:Neoplasm Seeding; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D014463:Ultrasonography; D014822:Vitreous Body / Q000000981:diagnostic imaging
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride