Korean J Radiol.  2001 Dec;2(4):197-203. 10.3348/kjr.2001.2.4.197.

The Use of Contrast-Enhanced Color Doppler Ultrasound in the Differentiation of Retinal Detachment from Vitreous Membrane

• Han SS
• Chang SK
• Yoon JH
• Lee YJ

• KMID: 754088
• DOI: http://doi.org/10.3348/kjr.2001.2.4.197

Abstract

OBJECTIVE
To compare the clinical utility of contrast-enhanced color Doppler US in the differentiation of retinal detachment (RD) from vitreous membrane (VM) with that of various conventional US modalities, and to analyze the enhancement patterns in cases showing an enhancement effect. MATERIALS AND METHODS: In 32 eyes examined over a recent two-year period, RD (n=14) and VM (n=18) were confirmed by surgery (n=28) or clinical follow-up (n=4). In all cases, gray-scale, color Doppler, and power Doppler US were performed prior to contrast injection, and after the intravenous injection of Levovist (Schering, Berlin) by hand for 30 seconds at a dose of 2.5 g and a concentration of 300 mg/mL via an antecubital vein, contrast-enhanced color Doppler US was performed. At Doppler US, the diagnostic criterion for RD and VM was whether or not color signals were visualized in membranous structures. RESULTS: Diagnostic accuracy was 78% at gray-scale US, 81% at color Doppler US, 59% at power Doppler US, and 97% at contrast-enhanced color Doppler US. The sensitivity of color Doppler US to color signals in RD increased from 57% to 93% after contrast enhancement. The enhancement patterns observed were signal accentuation (n=3), signal extension (n=2), signal addition (n=3), and new signal visualization (n=5). CONCLUSION: Contrast-enhanced color Doppler US was the most accurate US modality for differentiating RD from VM, showing a significantly increased signal detection rate in RD.

Keyword

Eye, hemorrhage; Eye, US; Retina; Ultrasound (US); Ultrasound (US), Doppler studies; Ultrasound (US), Contrast media

MeSH Terms

Adolescent
Aged
Comparative Study
*Contrast Media/administration & dosage
Diagnosis, Differential
Female
Human
Image Enhancement
Male
Middle Age
Polysaccharides/administration & dosage/*diagnostic use
Retinal Detachment/*ultrasonography
Sensitivity and Specificity
Ultrasonography, Doppler, Color/*methods
Vitreous Detachment/*ultrasonography

Figure

• 

  Fig. 1 A 50-year-old female with partial retinal detachment. A. Pre-contrast color Doppler US of the horizontally scanned left eye reveals two linear color signals with a short gap, representing retinal ramifications of an artery (red) and a vein (blue) along the detached retina. B. Contrast-enhanced color Doppler US image obtained 1 minute after the start of injection shows only signal accentuation without an increase in length.

• 

  Fig. 2 A 53-year-old male with total retinal detachment. A. Gray-scale image of the horizontally scanned left eye demonstrates a typical finding of retinal detachment, namely a thick 'funnel'-shaped membranous structure attached to the optic disc posteriorly (large arrow) and ora serrata anteriorly (small arrows). B. Pre-contrast color Doppler US reveals thick linear and spotty color signals in the posterior part of the membranous structure. C. Contrast-enhanced color Doppler US image obtained 4 minutes 17 seconds after the start of injection shows signal extension.

• 

  Fig. 3 A 71-year-old female with retinal detachment. A. Pre-contrast color Doppler US of the horizontally scanned left eye reveals multiple scattered linear and spotty color signals along the inward convex membranous structures in the vitreous cavity. B. Contrast-enhanced color Doppler US image obtained 23 seconds after the start of injection shows additional color signals in parts where color signals were not seen at pre-contrast imaging.

• 

  Fig. 4 A 50-year-old female with retinal detachment and vitreous membranes. A. Gray-scale image of the horizontally scanned left eye demonstrates multiple membranous structures of varying contour and thickness in the vitreous cavity. B. Pre-contrast color Doppler US reveals no color signals in the membranous structures. C. Power Doppler US is undiagnostic due to a large number of artefacts. D. Contrast-enhanced color Doppler US image obtained 3 minutes 1 second after the start of injection shows a short linear color signal in the thin linear structure attached in the vicinity of the ora serrata on the temporal side (arrow). Spectral Doppler US revealed an arterial wave form.

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