超声在原发性和复发性隆突性皮肤纤维肉瘤鉴别诊断中的作用  

Value of Ultrasonography in Differential Diagnosis of Primary and Recurrent Dermatofibrosarcoma Protuberans

作　　者：周胜 肖萤[1] 魏天虹[1] Zhou Sheng;Xiao Ying;Wei Tianhong(Department of Ultrasound,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院超声科,长沙市410008

出　　处：《中国超声医学杂志》2023年第7期824-828,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的隆突性皮肤纤维肉瘤(DFSP)是一种罕见的低度恶性软组织肉瘤,由于缺乏特异度影像学表现,临床易造成漏诊、误诊。本研究旨在探讨DFSP的临床及超声特点,明确超声在原发性和复发性DFSP鉴别诊断中的价值。方法回顾性分析19例DFSP的超声表现(包括7例原发性DFSP、12例复发性DFSP),提取声像图特征并绘制受试者工作特征(ROC)曲线分析其鉴别诊断效能。结果原发性DFSP和复发性DFSP在瘤体形态、内部回声特征、后方回声有无增强方面差异有统计学意义(P<0.05)。大多数原发性DFSP超声表现为形态规则、边界清晰,其内可见裂隙状高回声镶嵌,后方回声增强,血流信号较丰富,而大多数复发性DFSP表现为形态不规则、边界不清,其内可见裂隙状低回声镶嵌。两者鉴别以内部回声特征诊断效能最佳,其曲线下面积(AUC)为0.84。结论原发性和复发性DFSP具有一定的声像图特征,其中内部回声特征及后方回声有无增强在两者的鉴别诊断中有较高价值,可作为临床诊断的参考依据。Objective Dermatofibrosarcoma protuberans(DFSP)was a rare low-grade malignant soft tissue sarcoma,which could be easily misdiagnosed due to its lack of specific imaging features.This study was aimed to investigate the clinical and ultrasonographic characteristics of DFSP,and to clarify the value of ultrasound in the differential diagnosis of primary and recurrent DFSP.Methods Clinical and ultrasound data from a total of 19 patients(7 patients with primary DFSP and 12 patients with recurrent DFSP)were retrospectively collected and reviewed.The ultrasonic image features were summarized and the receiver operating characteristic(ROC)curve was drawn to analyze their differential diagnostic efficacy.Results There were statistically significant differences in the lesion configuration,internal echo characteristics and posterior echo types(P<0.05).Most of the lesions in the primary group showed regular shape,clear boundary,crack-like hyperechoic,hypervascularity and rear echo enhancement,while the lesions in the recurrent group showed irregularly shape,poorly-defined border and crack-like hypoechogenicity.The internal echo characteristics had the best efficiency in differential diagnosis,area under the curve(AUC)was 0.84.Conclusions Primary and recurrent DFSP have specific ultrasonic image features.The internal echo characteristics and posterior echo types have high value in the differential diagnosis.This may be useful for improving diagnostic accuracy in clinical practice.

关 键 词：超声 原发性 复发性 隆突性皮肤纤维肉瘤 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.5[医药卫生—诊断学]