浅表血管平滑肌瘤的MRI表现与病理对照  

MRI features of subcutaneous angioleiomyoma:comparison with pathological findings

作　　者：孙微 李峰 方军杰 SUN Wei;LI Feng;FANG Junjie(Department of Radiology,Hwa Mei Hospital,University of Chinese Academy of Sciences,Ningbo Institute of Life and Health Industry,University of Chinese Academy of Sciences,Ningbo 315010,China)

机构地区：[1]中国科学院大学宁波华美医院放射科,中国科学院大学宁波生命与健康产业研究院,浙江宁波315010

出　　处：《医学影像学杂志》2022年第8期1377-1380,共4页Journal of Medical Imaging

基　　金：浙江省医药卫生科技计划项目(编号:2019KY590)。

摘　　要：目的探讨浅表血管平滑肌瘤的MRI特点及病理基础。方法选取我院经手术病理证实的血管平滑肌瘤13例患者的MRI表现、临床及病理资料。结果浅表血管平滑肌瘤分别发生于足踝部4例,手部4例,鼻部2例,膝部1例,大腿1例,肘部1例;均位于皮下软组织内。病灶最大径为7~30 mm。MRI表现为T_(1)WI呈类圆形、等、稍高信号结节病灶,内见条状或树枝状高信号7例(7/13);13例在T_(2)WI均呈高信号,内可见不规则、条状或蚯蚓状等或稍高信号(13/13);9例T_(1)WI和T_(2)WI可见较薄的低信号边缘(9/13)。DWI及ADC呈稍高信号2例(2/2)。增强后不均匀明显强化3例(3/3)。病理表现为实性结节,质韧,色红或粉色,周围纤维包膜;镜下见肿物由分化成熟的平滑肌细胞和厚壁血管构成,部分可见扩张血管及玻璃样变性;免疫组化显示Vimentin(+)、Desmin(+)、SMA(+)、Caldesmon(+)。结论MRI表现为皮下边界清晰软组织结节,T_(2)WI呈不均匀高信号伴条状、蚯蚓状等或稍高信号,T_(1)WI内见条状或树枝状高信号,增强后明显强化,弥散不受限,可以帮助诊断血管平滑肌瘤。Objective To investigate the MRI features and pathological basis of subcutaneous angioleiomyoma combined with histopathological sections.Methods 13 cases of angioleiomyoma confirmed by operation and pathology in our hospital were retrospectively analyzed.Results There were 4 cases in ankle,4 cases in hand,2 cases in nose,1 case in knee,1 case in thigh and 1 case in elbow.The maximum diameter of the tumor was(7~30)mm.On T_(1)WI,7 cases(7/13)showed round and slightly high signal nodules with strip or dendritic high signal;All T_(2)WI showed high signal intensity with irregular,strip or earthworm like or slightly high signal intensity(13/13);9 cases showed thin and low signal edge on T_(1) and T_(2) weighted images(9/13).DWI and ADC showed slightly high signal in 2 cases(2/2).Inhomogeneous enhancement was observed(3/3)in the cases.Pathological findings were as follows:solid nodule,tough,red or pink in color,surrounded by fibrous capsule.Microscopically,the tumor was composed of differentiated smooth muscle cells and thick walled vessels,with dilated blood vessels and hyaline degeneration in part.Immunohistochemistry showed vimentin(+),desmin(+),SMA(+),and caldesmon(+).Conclusion MRI features clearly show subcutaneous boundary soft tissue nodules,T_(2)WI with uneven high signal with strip,earthworm like or slightly high signal,T_(1)WI can see strip or dendritic high signal,enhanced significantly,diffusion is not limited,which can help the diagnosis of angioleiomyoma.

关 键 词：血管平滑肌瘤 良性肿瘤 皮下软组织 磁共振成像 

分 类 号：R738.6[医药卫生—肿瘤] R445.2[医药卫生—临床医学]