恶性黑色素瘤影像诊断  

Imageological diagnosis of malignant melanoman attached

作　　者：董道先[1] 王立非[1] 罗正益[1] 梁益贞[1] 刘伟南[1] 姚霞飞[1] 金红华[1] 

机构地区：[1]广州中医药大学祈福医院放射科,广东广州511495

出　　处：《罕少疾病杂志》2008年第6期29-33,共5页Journal of Rare and Uncommon Diseases

摘　　要：目的提高对恶性黑色素瘤的认识和诊断水平。方法收集我院恶性黑色素瘤病例3例,其临床病史详细、影像资料齐全,并复习相关文献。结果1例后背部皮肤含黑色素的恶性黑色素瘤患者,原发灶和转移灶于MRI均表现为特征性的短T1短T2信号,CT不具备特征性;1例是不含黑色素的外阴恶性黑色素瘤清扫术后患者,MRI呈等T1等T2信号,增强后不均匀强化,不具备特征性;另一例眼球恶性黑色素瘤术后多发转移的患者,CT检查平扫呈等低密度,增强后不均匀环形强化,不具备特征性。结论恶性黑色素瘤多发生于皮肤、内脏各种组织器官,其中皮肤恶性黑色素瘤多见,以下肢、外阴、肛周最多,鲜有影像报道;发生于内脏的恶性黑色素瘤多因具备特征性的MRI信号得以诊断,而不含黑色素的恶性黑色素瘤影像表现无特征性,诊断困难;CT检查不具备特征性,对于怀疑恶性黑色素瘤的患者,应首选MRI检查。恶性黑色素瘤容易发生广泛的转移,要提高对恶性黑色素瘤的诊治水平。Objective To improve the understanding of malignant melanoma and its the diagnostic level. Methods Detailed clinical history, imagelolgical of 3 cases with malignant melanoma were collected and correlated articles were reviewed. Results 1 case contained melanin origined from skin of the back, both the primary and metastatic lesions appeared to be specific hyperintense in T^WI and hypointense in T2WI, but there was no specific feature in CT images. 1 postoperative case from the cunnus which non melanin contained, matastatic lesions were shown isointense in TzWI and T2WI, heterogeneously enhanced in the contrast, we see no specific feature in this case. Another case from the eye globe was nonspecific, in which postoperative multiple metastatic lesions were shown low to medium density in CT plain scans and heterogeneously enhanced in CE images. Conclusion Malignant melanoma can occur from skin, or any internal organs, among which skin melanoma is more frequently seen, especially in the skin of legs, cunnus, and crissum. However they have been rarely reported. Malignant melanomas of the internal organs can be easily diagnosed with its specitic MRI features, while the non-melanin contained melanoma which has no imageological specific feature are more difficult to be diagnosed. Because CT examination has no specific feature, MRI should be the first choice, for the suspect patient of malignant melanoma. Intensive matastasis of malignant melanomas can happen easily, so diagnostic and therapeutic level need to be improved.

关 键 词：恶性黑色素瘤 影像诊断 文献复习 

分 类 号：R739.5[医药卫生—肿瘤] R445.2[医药卫生—临床医学]