韧带样纤维瘤病超声征象特点  

Ultrasonographic findings of desmoid fibromatosis

作　　者：吴毅华[1] 余铖[1] 谢明星[1] 武彧[1] 宋越[1] 杨丽 王静[1] Wu Yihua;Yu Cheng;Xie Mingxing;Wu Yu;Song Yue;Yang Li;Wang Jing(Department of Ultrasound Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology Clinical Research Center for Medical Imaging in Hubei Province Hubei Province Key Laboratory of Molecular Imaging,Wuhan 430022,China;Department of Ultrasound,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430064,China)

机构地区：[1]华中科技大学同济医学院附属协和医院超声医学科,湖北省影像医学临床医学研究中心,分子影像湖北省重点实验室,武汉430022 [2]武汉科技大学附属天佑医院超声科,武汉430064

出　　处：《中国医师杂志》2022年第9期1290-1293,共4页Journal of Chinese Physician

基　　金：国家自然科学基金(82171961,81601540)。

摘　　要：目的探讨韧带样纤维瘤病的超声征象特点,为临床管理提供依据。方法回顾性分析华中科技大学同济医学院附属协和医院2016年—2021年经病理证实的22例韧带样纤维瘤病的超声图像及临床资料,分析病变部位、大小、形态、边界、内部回声、后方回声、与周围组织关系及血流等特征。结果本组研究22例患者病变最大径0.8~11.3(5.2±2.4)cm。(1)腹外型17例,形态呈不规则形10例,梭形4例,椭圆形3例;10例病变边界不清晰,沿肌肉、筋膜或脂肪组织呈浸润性分布;11例内部呈不均匀低回声,4例内见条状或斑片状强回声;5例伴后方回声增强;彩色多普勒血流成像(CDFI)血流分级:0级2例,1级7例,2级7例,3级1例。(2)腹壁型5例,形态呈椭圆形2例、梭形2例,不规则形1例;3例边界不清晰,沿肌肉呈浸润性分布;4例内部呈不均匀低回声;1例伴后方回声增强;CDFI血流分级:1级2例,2级2例,3级1例。结论典型韧带样纤维瘤病的声像图具有一定特征,结合患者病史及临床表现,可为该病临床管理提供重要依据。Objective To explore the ultrasonographic features of desmoid fibromatosis and provide evidence for clinical management.Methods The ultrasonic images and clinical data of 22 cases of desmoid fibromatosis confirmed by pathology in the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from 2016 to 2021 were retrospectively analyzed.The location,size,shape,boundary,internal echo,posterior acoustic enhancement,relationship with surrounding tissues and blood flow of the lesion were evaluated.Results The maximum diameter of lesions in 22 patients ranged from 0.8 cm to 11.3 cm(5.2±2.4)cm.(1)There were 17 cases of extra-abdominal shape:10 cases of irregular shape,4 cases of spindle shape,and 3 cases of oval shape.In 10 cases,the lesion boundary was not clear,and the lesion was infiltrated along the muscle,fascia or adipose tissue.Uneven hypoechogenicity was found in 11 cases,and strip or patchy strong echo was found in 4 cases.5 cases with posterior echogenicity enhancement;color Doppler flow imaging(CDFI)blood flow classification:grade 0 in 2 cases,grade 1 in 7 cases,grade 2 in 7 cases,and grade 3 in 1 case.(2)Abdominal wall type in 5 cases:oval shape in 2 cases,spindle shape in 2 cases,irregular shape in 1 case;In 3 cases,the boundary was not clear and was infiltrative along the muscle.Inhomogeneous hypoecho was found in 4 cases.Posterior echogenicity was enhanced in 1 case.CDFI blood flow classification:grade 1 in 2 cases,grade 2 in 2 cases,grade 3 in 1 case.Conclusions The sonograms of typical desmoid fibromatosis have certain features.Combined with the patient′s history and clinical manifestations,they can provide an important basis for the clinical management of the disease.

关 键 词：纤维瘤病 侵袭型 超声检查 多普勒 彩色 

分 类 号：R738.6[医药卫生—肿瘤] R445.1[医药卫生—临床医学]