6例盆腔侵袭性血管粘液瘤影像特征  

Imaging manifestations of 6 cases of aggressive angiomyxoma

作　　者：陈国丹 周勤 刘治玲 李福艳 朱庆章 于永梅[6] 曾庆师[1] CHEN Guodan;ZHOU Qin;LIU Zhiling;LI Fuyan;ZHU Qingzhang;YU Yongmei;ZENG Qingshi(Department of Radiology,Shandong Provincial Qianfoshan Hospital,Shandong University,Jinan 250014,Shandong,China;Department of Radiology,First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,Guangdong,China;Department of Radiology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,Shandong,China;Department of Radiology,Shandong Medical Imaging Research Institute,Jinan 250021,Shandong,China;Department of Radiology,The People's Hospital of Lanling,Lanling 277700,Shandong,China;Department of Radiology,Jining No.1 People's Hospital,Jining 272000,Shandong,China)

机构地区：[1]山东大学,山东省千佛山医院放射科,山东济南250014 [2]中山大学第一附属医院放射科,广东广州510080 [3]山东第一医科大学附属省立医院医学影像科,山东济南250021 [4]山东省医学影像学研究所放射科,山东济南250021 [5]兰陵县人民医院放射科,山东兰陵277700 [6]济宁市第一人民医院放射科,山东济宁272000

出　　处：《山东大学学报（医学版）》2021年第2期55-59,共5页Journal of Shandong University:Health Sciences

基　　金：山东省重点研发计划项目(2019GSF108079)。

摘　　要：目的探讨盆腔侵袭性血管粘液瘤(AA)的影像特征及其与盆腔实体肿瘤影像的初步鉴别。方法收集2012年4月至2020年5月具有术前影像学检查的AA患者6例(AA组)以及具有相似临床和影像表现的盆腔肿块待诊患者14例(对照组)的资料,以病理学诊断为金标准,对其临床及影像资料进行回顾性分析和鉴别,Fisher精确检验用于AA组和对照组的统计学分析。结果AA组中,6例(6/6)T_2WI均表现为高信号,增强扫描5例(5/6)明显强化,1例(1/6)中度强化,内部均有"分层样"或"漩涡样"低信号和弥散受限,其中5例(5/6)跨盆膈生长延伸至会阴,3例(3/6)表现出"手指样"突起,3例(3/6)合并囊变。对照组中血管肌纤维母细胞瘤与AA组影像表现最为相似。鉴别时,肿块跨盆膈延伸会阴(P<0.001)、"漩涡样"或"分层样"表现(P<0.001)与对照组之间的差异具有统计学意义。结论AA在MRI上具有一定的影像特点,发生于女性的盆腔及会阴区,出现特征性"分层状"或"漩涡样"改变的软组织肿瘤应该考虑AA的可能。Objective To explore the imaging characteristics of pelvic aggressive angiomyxoma(AA)and to differentiate it from other pelvic masses.Methods The clinical and imaging data of 6 AA patients AA group and 14 patients with pelvic masses(controls)who had similar clinical and imaging manifestations treated during April 2012 and May 2020 were retrospectively analyzed.Fishers exact test was used for statistical analysis.Results In the AA group,all cases showed high signal on T_(2)WI.Contrast-enhanced scan showed significant enhancement in 5 cases,and moderate enhancement in 1 case."Layering"or"swirling"low signals and diffusion restriction were observed in all cases.The angiomyxoma crossed the pelvic diaphragm and extended to perineum in 5 cases,showed"finger-like"projections in 3 cases,and had cystic changes in 3 cases.In the control group,the imaging manifestations of angiomyofibroblastoma(AMF)were the most similar to those of AA group.There were significant differences in the neoplasm crossing the pelvic diaphragm and extending to the perineum(P<0.001),and"layered"or"swirled"signals(P<0.001)between the two groups.Conclusion AA has certain imaging characteristics on MRI,commonly arising in the pelvic cavity and perineum in females."Layered"or"swirled"signals in soft tissue neoplasms may indicate the presence of AA.

关 键 词：侵袭性血管粘液瘤 磁共振 血管肌纤维母细胞瘤 盆腔肿物 

分 类 号：R737.3[医药卫生—肿瘤]