儿童眼眶周淋巴管畸形合并静脉畸形误诊为动静脉畸形临床分析  

Clinical Analysis of Children with Periorbital Lymphatic Malformation Complicated with Venous Malformation Misdiagnosed as Arteriovenous Malformation

作　　者：焦玉浩 陈程浩 李三林 郭向峰 曹佳捷 熊祎 狄奇 申刚 JIAO Yuhao;CHEN Chenghao;LI Sanlin;GUO Xiangfeng;CAO Jiajie;XIONG Yi;DI Qi;SHEN Gang(Department of Interventional Hemangioma,Children's Hospital,Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院介入血管瘤科,北京100020

出　　处：《临床误诊误治》2024年第18期5-10,共6页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨眼眶周淋巴管畸形的特点及误诊原因。方法回顾性分析2023年收治的儿童眼眶周淋巴管畸形合并静脉畸形误诊为动静脉畸形1例的临床资料。结果该例患儿出生后发现右眼肿胀,先后误诊为血管瘤和动静脉畸形,分别进行硬化治疗和动静脉畸形组织胶栓塞,症状有所缓解,但间断反复发作。经过完善磁共振成像检查和在超声引导下局部穿刺眶周囊腔术中抽出淋巴液确诊为淋巴管畸形合并静脉畸形。误诊时间11年。确诊后经过硬化治疗联合西罗莫司治疗后,患儿症状得到明显缓解,随访期间未再次复发。结论眶周淋巴管畸形合并静脉畸形易误诊,需要联合影像检查和多学科团队进行共同评估,减少误诊。Objective To investigate the characteristics and causes of misdiagnosis of periorbital lymphatic malformation.Methods The clinical data of a child with periorbital lymphatic malformation combined with venous malformation who was misdiagnosed as arteriovenous malformation and treated in 2023 were retrospectively analyzed.Results Swelling of the right eye was found in this child after birth,which was misdiagnosed as hemangioma and arteriovenous malformation successively.Sclerotic treatment and glue embolization of arteriovenous malformation tissue were performed respectively,and the symptoms were relieved to some extent,which were intermittent and recurrent.The patient was diagnosed with lymphatic malformation combined with venous malformation after performing magnetic resonance imaging examination and extraction of lymphatic fluid during ultrasound-guided local puncture of the periorbital capsule.The misdiagnosis lasted 11 years.After diagnosis and treatment with sclerotherapy combined with Sirolimus treatment,the patient's symptoms were significantly relieved and no recurrence occurred during follow-up.Conclusion Periorbital lymphatic malformation combined with venous malformation is more likely to be misdiagnosed,and joint imaging examination and multidisciplinary team evaluation are needed to reduce misdiagnosis.

关 键 词：眶周 淋巴管畸形 误诊 动静脉畸形 硬化疗法 磁共振成像 儿童 

分 类 号：R725.5[医药卫生—儿科]