四肢血管平滑肌瘤的CT及MRI特征和鉴别诊断  

CT and MRI features and differential diagnosis of angioleiomyoma of the extremities

作　　者：凌丽芳 李静 王中秋 王智涛 陈苓珊 韩梅 LING Lifang;LI Jing;WANG Zhongqiu;WANG Zhitao;CHEN Lingshan;HAN Mei(Department of Radiology,Jiangsu Hospital of Traditional Chinese Medicine,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院(江苏省中医院)放射科,南京210029 [2]南京中医药大学附属医院(江苏省中医院)病理科,210029

出　　处：《临床肿瘤学杂志》2024年第12期1237-1240,共4页Chinese Clinical Oncology

摘　　要：目的 分析四肢血管平滑肌瘤的CT、MRI影像特征,提高临床对血管平滑肌瘤的认识,减少误诊。方法 选取经手术病理证实的10例四肢血管平滑肌瘤,上肢3例、下肢7例,8例患者的病灶处于长期稳定状态并短期有所增大后6例出现疼痛,2例为偶然发现。所有肿瘤位于四肢皮下浅表处,病灶最大径为7~35 mm。其中1例行CT检查、8例行MRI检查、1例行CT及MRI检查,分析患者的临床资料及CT、MRI表现,总结影像特征。结果 2例CT平扫瘤体呈软组织密度伴内部粗大钙化;MRI表现为T1WI类圆形等信号,T_(2)压脂像呈不均匀高信号,较大瘤体内部可见暗网状征5例,瘤体周围血管征6例均无明显弥散受限,MRI增强扫描增强呈渐进性显著强化。结论 血管平滑肌瘤的CT、MRI影像表现具有一定的特征性,能够反映其组织学成分,有助于术前的精准诊断。Objective To analyze the CT and MRI imaging features of angioleiomyoma of the extremities,hoping to improve clinical understanding of angioleiomyoma and diminish misdiagnosis.Methods Ten cases of angioleiomyoma of the extremities confirmed by surgical pathology were selected,including 3 cases of the upper limbs and 7 cases of the lower limbs.In 8 cases,the lesions were in a long-term stable state and increased in size for a short period of time followed by pain in 6 cases and incidental findings in 2 cases.All tumors were located in the superficial subcutaneous area of the limbs,with the maximum diameter of the lesions ranging from 7 to 35 mm.One case was examined by CT,8 cases were examined by MRI,and 1 case was examined by both CT and MRI.Clinical data of the patients and the performance of CT and MRI were analyzed,and the imaging characteristics were summarized.Results In 2 cases,the tumors showed soft tissue density with internal gross calcification on CT scan.MRI showed rounded isosignal on T 1 WI and inhomogeneous high signal on T_(2) compression fat image.Dark reticular signs were seen within the larger tumors in 5 cases and peritumoral vascular signs in 6 cases without significant diffusion limitation.Enhanced MRI showed progressive significant enhancement.Conclusion The CT and MRI images of angioleiomyoma have certain characteristics and can reflect its histological components,which can help in precise preoperative diagnosis.

关 键 词：血管平滑肌瘤 四肢 计算机体层成像 磁共振成像 鉴别诊断 

分 类 号：R738.6[医药卫生—肿瘤]