超声诊断肢体上皮样肉瘤的临床价值  

Clinical value of ultrasound in the diagnosis of limb epithelioid sarcoma

作　　者：秦晓婷 郭稳 王丹丹 陈涛 QIN Xiaoting;GUO Wen;WANG Dandan;CHEN Tao(Department of Ultrasound,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院超声科,北京市100035

出　　处：《临床超声医学杂志》2024年第7期554-557,共4页Journal of Clinical Ultrasound in Medicine

基　　金：北京市医院管理中心第三期“扬帆”计划临床技术创新项目(YGLX202319)。

摘　　要：目的探讨超声在肢体上皮样肉瘤诊断中的临床价值。方法选取我院经手术病理证实为肢体上皮样肉瘤患者43例,分析其术前超声图像特征,并随访其复发情况。结果43例肢体上皮样肉瘤超声均明确提示病变位置,定位准确率100%;声像图表现均呈团块状低回声,无包膜,平均最大径(5.73±4.99)cm,以实性为主(81.4%,35/43),边界多不清晰(55.8%,24/43),形态多不规则(88.4%,38/43),内部回声多不均匀(95.3%,41/43),多为单发(72.1%,31/43),Adler血流分级多为Ⅲ级(53.5%,24/43)。超声明确提示软组织肿物42例,另有1例患者肿物感不明显,超声提示为神经病变,瘢痕粘连。术后随访3个月~8年,出现复发并再次手术者22例,超声均直接提示复发,声像图表现均为回声不均匀的实性低回声,边界多不清晰(68.2%,15/22),形态多不规则(72.7%,16/22),Adler血流分级均为Ⅰ级。结论超声不仅可在术前明确肢体上皮样肉瘤的病变范围及其周围组织受累情况,术后亦可动态随访,具有重要的临床价值。Objective To explore the clinical value of ultrasound in the diagnosis of limb epithelioid sarcoma.Methods A total of 43 patients with limb epithelioid sarcoma confirmed by surgery and pathology were collected.The preoperative sonographic characteristics of the lesions were analyzed,and recurrence was followed up.Results Ultrasound imaging in all 43 cases of limb epithelioid sarcoma clearly identified the lesion location with a 100%localization accuracy.The sonographic characteristics included lump-like hypoechoic masses without a capsule,with an average maximum diameter of(5.73±4.99)cm,mainly solid(81.4%,35/43),unclear boundary(55.8%,24/43),irregular shape(88.4%,38/43),uneven internal echo(95.3%,41/43),mostly single lesions(72.1%,31/43),and predominantly classified as Adler gradeⅢfor blood flow(53.5%,24/43).Ultrasound identified soft tissue masses in 42 cases,while the tumor was not apparent and diagnosed as a neuropathic lesion with scar adhesion by ultrasound in 1 case.Postoperative follow-up ranging from 3 months to 8 years revealed that ultrasound detected recurrence in 22 cases,with uneven solid hypoechoic masses with unclear margins(68.2%,15/22),irregular shapes(72.7%,16/22),and blood flow grading of Adler gradeⅠ.Conclusion Ultrasound can clearly delineate the extent of limb epithelioid sarcoma lesions and surrounding tissue involvement preoperatively,and also serves as a valuable tool for dynamic postoperative follow-up.

关 键 词：超声检查 上皮样肉瘤 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]