目的：探讨超声造影时间参数在脉络膜占位性病变分型诊断中的应用价值。

方法：选取2020年6月至2024年1月在西安市人民医院(西安市第四医院)就诊并行超声造影的脉络膜占位性病变患者，根据最终临床诊断及病理结果分为良性组(脉络膜血管瘤)、恶性组(脉络膜黑色素瘤)和积血组(脉络膜下积血)。通过分析超声造影的特点、造影参数(如上升时间、达峰时间、洗出时间等)及不良反应发生率，评估其诊断效果。

结果：本研究纳入脉络膜占位性病变患者120例120眼，良性组、恶性组和积血组各40例40眼。良性组患者年龄45-70(平均57.5±12.4)岁，男19例，女21例； 恶性组患者年龄43-72(平均年龄56.9±13.1)岁，男23例，女17例； 积血组患者年龄40-61(平均54.4±9.7)岁，男22例，女18例。良性组多表现为均匀高灌注，多呈现“快进慢出”的灌注模式； 恶性组多表现为不均匀高灌注，呈现“快进快出”的灌注模式； 积血组未见明显灌注，呈现“无进出”的灌注模式。三组患者在超声造影特征和参数上表现出显著差异，在不良反应发生率方面无显著差异。

结论：超声造影能够显著提高脉络膜占位性病变的诊断准确性，为临床提供重要的参考依据，且具有较高的安全性。

METHODS: Patients with choroidal space-occupying lesions who underwent CEUS at Xi'an People's Hospital(Xi'an Fourth Hospital)between June 2020 and January 2024 were enrolled. According to the final clinical diagnosis and pathological findings, the patients were divided into a benign group(choroidal hemangioma), a malignant group(choroidal melanoma), and a hemorrhage group(subchoroidal hemorrhage). CEUS characteristics and contrast parameters, including rise time(RT), time to peak(TP), and washout time(WT), as well as the incidence of adverse reactions, were analyzed to evaluate the diagnostic value of CEUS.

RESULTS:A total of 120 patients(120 eyes)with choroidal space-occupying lesions were included, with 40 patients(40 eyes)in each group. The patients in the benign group were aged 45-70(mean age 57.5±12.4 )y, including 19 males and 21 females; those in the malignant group were aged 43-72(mean age 56.9±13.1 )y, including 23 males and 17 females; and those in the hemorrhage group were aged 40-61(mean age 54.4±9.7 )y, including 22 males and 18 females. The benign group predominantly exhibited homogeneous hyperenhancement with a “fast-in, slow-out”perfusion pattern, whereas the malignant group mainly showed heterogeneous hyperenhancement with a “fast-in, fast-out”perfusion pattern. No obvious enhancement was observed in the hemorrhage group, exhibiting a “no-in, no-out” perfusion pattern. Significant differences were found among the three groups in CEUS characteristics and quantitative parameters, whereas no significant difference was observed in the incidence of adverse reactions.

CONCLUSION: CEUS can significantly improve the diagnostic accuracy of choroidal space-occupying lesions and may serve as a useful reference for clinical decision-making, with a favorable safety profile.