肌肉血管瘤影像学特征  

Imaging diagnose of intramuscular hemangioma

作　　者：宋其韬[1] 王林森[1] 

机构地区：[1]天津医院放射科,300211

出　　处：《中国骨肿瘤骨病》2006年第4期218-220,252,共4页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的探讨肌肉血管瘤影像学诊断价值。方法收集1990年10月～2004年12月157例肌肉血管瘤的影像学资料进行回顾性分析,157例中肢体肌肉血管瘤共计131例占83.4%,躯干26例占16.6%。全部病例均经手术、病理证实。影像学资料包括X线平片、静脉造影、CT和MRI。结果静脉石的形成主要以肢体远端为主(131/43)占32.8%,其次为上臂及大腿肌群(26/4)占15.4%,躯干部肌群发生率最低;28例行CT平扫检查、3例强化,19例发现点状或小结节状静脉石,3例强化显示病变明显强化并可见引流静脉;62例行MRI检查,病变常侵及一组肌肉,T1WI以等信号为主并夹杂“蚯蚓”状流空血管影,T2WI则表现为不均匀性高信号;9例行血管造影,其中6例进行了传统的静脉血管造影,受累肌肉内多条粗大的静脉血管并交织呈网状,2例血管呈“串珠状”改变,3例行DSA检查毛细血管团显影伴数条粗大的引流静脉与毛细血管交织呈网状。结论MRI对肌肉血管瘤敏感性极高,可明确肿瘤累及的范围,对制订手术计划有非常重要的帮助。X线平片作为筛选手段,一旦发现静脉石也可明确诊断,但对于病变范围的确定仍需MRI检查。Objective To explore the imaging diagnostic value of intramuscular hemangioma （IMH）. Methods The imaging materials of 157 pathological confirmed IMH were retrospectively analyzed from October 1990 to August 2004. The imaging examination include X-ray（plain flim）and phlebography and CT and MRI. Results of 157 cases, there were 131 extremital hemangioma （83.4%）. The vein-stone mostly was found in the distal extremity （32.8%）, secondly located in the muscles of upper arm and thigh（ 15.4% ）. The IMH of body part was rare. The spot or nodular vein-stone were showed by CT plain scan in 19 case. 3 case enhancement show remarkable enhancement and draining vein. Hemangioma easily involved a series of muscles and show isointensity T：WI signal with flow empty signal and heterogeneous T2WI signal. 9 phlebography and 3 DSA imaging showed a lot of thick vein mingled to form reticular shape. The vein looks like beaded in 2 cases. Conclusions The MRI sensitiveness for IMH is high and can confirm the range of involvement, as well as be useful to plan operation. The plain film can be used as a selected method. The veinstone is charactical.

关 键 词：血管瘤 软组织 影像学 诊断 

分 类 号：R738.7[医药卫生—肿瘤]