侵袭性血管黏液瘤的影像学特征并文献复习  

Imaging features of aggressive angiomyxoma and literature review

作　　者：张芳芳 李军[1] 赵玉洁 于彤 宁春平[1] Zhang Fangfang;Li Jun;Zhao Yujie;Yu Tong;Ning Chunping(Department of Abdominal Ultrasound,2Department of Pathology,3Department of Radiology,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院腹部超声科,266000 [2]青岛大学附属医院病理科,266000 [3]青岛大学附属医院放射科,266000

出　　处：《中华诊断学电子杂志》2024年第4期254-259,共6页Chinese Journal of Diagnostics(Electronic Edition)

基　　金：科技部国家重点研发计划项目(2022YFC2503302)。

摘　　要：目的探讨侵袭性血管黏液瘤(AAM)的影像学特征。方法回顾性分析2016年1月至2023年11月于青岛大学附属医院腹部超声科就诊的5例经术后病理证实为AAM患者的超声、CT和MRI等影像学资料,并复习文献。结果5例AAM患者均为女性,肿块均位于会阴或盆腔内,肿块最大径7~32 cm;1例患者MRI增强示会阴部肿块特征性分层样强化;2例CT增强后为病灶不均匀轻度或轻-中度强化,包膜明显强化,其中1例肿块内分隔及包膜明显增强;3例超声表现为内回声不均匀,彩色多普勒超声均提示肿块内多发点条状血流信号,其中2例为低回声团块,并内见高回声呈层状分布,形态不规则,呈“指状”或“舌状”向周围组织延伸。1例计算机体层血管成像(CTA)、CT静脉造影(CTV)示肿块内呈放射状分布的供血动静脉。结论影像学发现在会阴或骨盆内具有特征性内部层状形态或向骨盆两侧延伸呈“指状”或“舌状”生长的内回声不均匀的肿块时,应考虑诊断为AAM可能。Objective To investigate the imaging features in patients with aggressive angiomyxoma(AAM).Methods The ultrasonography,CT and magnetic resonance imaging(MRI)data of 5 patients with AAM confirmed by postoperative pathology were retrospectively analyzed from January 2016 to November 2023 in the Department of Abdominal Ultrasound of Affiliated Hospital of Qingdao University,and the literature was reviewed.Results All the 5 patients with AAM were female,and the masses were located in the perineum or pelvic cavity,with the maximum diameter of 7-32cm.MRI enhancement showed characteristic layered enhancement of perineal mass in 1 patient.After CT enhancement,2 cases showed uneven mild or light-moderate enhancement,and the envelope was significantly enhanced,and the internal septa and envelope were significantly enhanced in 1 case.The ultrasonography of 3 cases showed uneven internal echoes,and color Doppler ultrasonography indicated multiple streaks of blood flow signals within the masses,of which 2 cases were hypoechoic masses,with layered distribution high echoes,irregular in shape,and extending to surrounding tissues in a"finger"like or"tongue"like shape.CT angiography(CTA)and CT venography(CTV)showed radial distribution of blood-supply arteries and veins in the mass in 1 case.Conclusion The diagnosis of AAM should be considered when imaging findings reveals a mass with characteristic internal laminar shape within the perineum or pelvis,or an uneven internal echo that extends to both sides of the pelvis in a"finger like"or"tongue like"shape.

关 键 词：侵袭性血管黏液瘤 超声检查 间叶组织肿瘤 软组织肿瘤 影像学检查 

分 类 号：R732.2[医药卫生—肿瘤]