纤维脂肪性血管性病变的MRI表现分析  

MRI features of fibro-adipose vascular anomaly

作　　者：李海婷[1] 胡文笳[2] 樊红光[1] 董长宪[3] 龚毓宾 范盼红 史大鹏[1] Li Haiting;Hu Wenjia;Fan Hongguang;Dong Changxian;Gong Yubin;Fan Panhong;Shi Dapeng(Department of Medical Imaging,People’s Hospital of Henan Province,Zhengzhou 450003,China;Department of Ultrasound,People’s Hospital of Henan Province,Zhengzhou 450003,China;Department of Hemangioma Surgery,People’s Hospital of Henan Province,Zhengzhou 450003,China;Department of Pathology,People’s Hospital of Henan Province,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院医学影像科,郑州450003 [2]河南省人民医院超声科,郑州450003 [3]河南省人民医院血管瘤科,郑州450003 [4]河南省人民医院病理科,郑州450003

出　　处：《中华整形外科杂志》2023年第3期261-265,共5页Chinese Journal of Plastic Surgery

摘　　要：目的:探讨纤维脂肪性血管性病变(FAVA)的MRI特征。方法:回顾性分析2016年1月至2021年6月河南省人民医院临床及病理证实的FAVA患者的临床资料。通过分析FAVA的MRI影像表现,包括病变的部位、形态、信号、强化程度、内部结构、外周结构及其他影像特点,总结其MRI特征。结果:全组共纳入30例患者,男13例,女17例,年龄(18.5±12.8)岁(4~53岁)。病变部位:小腿12例、大腿12例、上臂4例、前臂1例、躯干1例。下肢有24例。所有病例均累及肌层,其中浅肌层21例,深肌层7例,深浅肌层均受累2例,浅肌层受累23例。受累肌肉较多者为股四头肌10例,腓肠肌7例。病变形态:所有病灶均为平行于肌肉长轴生长的肌内实性肿块,其中11例局灶型,11例局部浸润型,8例弥漫型。MRI表现:病灶均呈混杂信号,T1WI有28例在中高信号的背景上见云絮状、条带状、斑片状高信号分布区;脂肪抑制T2WI 30例均在高信号的背景上见树枝状、条带状、云絮状中低信号分布区;增强扫描病变区呈中等至明显不均匀渐进性强化;27例病灶内部见形状不一的脉管影,28例病灶邻近可见引流静脉影,后者中24例位于病灶近心端;26例病灶外周可见筋膜尾征,其中23例位于病灶上下两端。结论:FAVA的MRI多表现为下肢浅肌层内的平行于肌肉长轴的实性肿块,T1WI中高信号背景上的云絮状、条带状、斑片状高信号,脂肪抑制T2WI高信号背景上的树枝状、条带状、云絮状中低信号,对FAVA的诊断有提示意义,结合筋膜尾征和引流静脉及临床表现等可以在一定程度上明确诊断FAVA,为其临床决策提供参考依据。Objective To investigate the MRI features of fibro-adipose vascular anomaly(FAVA).Methods The clinical,pathological and MRI data of the FAVA patients confirmed clinically and pathologically in Henan Provincial People’s Hospital from January 2016 to June 2021 were retrospectively analyzed,including 17 females and 13 males,aged 4-53(18.5±12.8)years.Through the analysis of the MRI images of FAVA performance,including the lesion area,shape,signal,the degree of reinforcement,inner structure,outer structure and other image characteristics,summarize the MRI features.Results The lesions located at the lower leg(12 cases),thigh(12 cases),upper arm(4 cases),forearm(1 case)and trunk(1 case).Twenty-four case of lower limbs.All cases involved the muscular layer,including 21 cases of superficial muscle layer,7 cases of deep muscle layer,and 2 cases of both.Twenty-three cases of superficial muscle layer.Most of the affected muscles were quadriceps femoris and gastrocnemius.Morphology:all lesions were intramuscular solid masses growing parallel to the long axis of the muscle.There were 11 cases of focal type,11 cases of locally infiltrating type,and 8 cases of diffuse type.MRI findings:all lesions showed mixed signal.On T1WI,28 cases showed cloud-like,band-like and patchy high signal on the background of medium and high signal.On T2WI-FS,all the 30 cases showed low to medium signal areas on the background of high signal,which were dendrimer,ribbon and cloud-like.The lesions showed moderate to obvious heterogeneous progressive enhancement.Twenty-seven lesions had different shapes of vascular shadow,and 28 lesions had drainage vein shadow adjacent to the lesions,24 of which were located at the proximal end of the lesions.Fascial tail sign was found at the periphery of the lesions in 26 cases,of which 23 cases were located at the upper and lower ends of the lesions.Conclusion FAVA is a complex vascular malformation with unclear pathological classification.MRI usually shows a solid mass in the superficial muscle layer of the lowe

关 键 词：血管瘤 脉管畸形 纤维脂肪性血管性病变 磁共振成像 诊断 

分 类 号：R543[医药卫生—心血管疾病] R445.2[医药卫生—内科学]