Abstract
PURPOSE: To report the color Doppler imaging (CDI) features of 17 patients with retinal pigment epithelium (RPE) neoplasms. DESIGN: Retrospective, observational case series. PARTICIPANTS: Seventeen patients with RPE adenoma/adenocarcinoma. METHODS: Contrast-enhanced color Doppler ultrasonography (CDU) was performed in 16 patients with RPE adenoma and in one patient with adenocarcinoma. RESULT: All 17 RPE neoplasms showed well-defined margins. An oval mass was observed in 11 tumors, a lenticular-shaped mass in four tumors, and a flat mass in two tumors. On CDI, RPE lesions showed homogeneous reflectivity of moderate intensity with no choroidal excavation. After the contrast-enhanced administration of sulfur hexafluoride, mild enhancement was identified in six tumors and moderate enhancement in 11 tumors. In all 17 RPE neoplasms, contrast-enhanced CDU time-intensity curves (TICs) exhibited fast fill-in and slow washout-shaped curves with the dominant vessel within RPE lesions. A "black-linear" sign (defined as a low signal intensity-linear zone located between the tumor and enhanced choroid on CDI) was noted in all 17 patients with RPE neoplasms. CONCLUSIONS: This preliminary study noted a "black-linear" sign on CDI of RPE lesions for the first time. The novel sign may be a diagnostic characteristic of RPE neoplasms and may help to distinguish this rare entity from uveal melanomas (UMs).