侵袭性血管瘤病临床及影像表现分析  

Clinical and Imaging Analysis of Invasive Angiomatosis

作　　者：徐茂丽 阮志兵 尹义 刘亚东 文勇 黄瑾瑾 XU Maoli;RUAN Zhibing;YIN Yi(Department of Radiology,The Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou Province 550004,P.R.China)

机构地区：[1]贵州医科大学附属医院,550004 [2]贵州医科大学,550004

出　　处：《临床放射学杂志》2025年第4期749-755,共7页Journal of Clinical Radiology

基　　金：贵州省科技计划资助项目(黔科合基础-ZK[2023]);贵州医科大学附属医院国家自然科学基金培育计划资助项目(编号:gyfynsfc-2021-39)。

摘　　要：目的 探讨侵袭性血管瘤病的临床与影像表现特点,提高对该病认识及早期诊断的水平。方法 回顾性分析经病理确诊为侵袭性血管瘤病的12例患者的临床资料与影像学特征。结果 12例病例中男性6例,女性6例;3例患者病变部位有局部外伤史,表现为外伤后疼痛,2例为体检发现,5例为无明显诱因疼痛,1例表现为局部压痛,1例表现为活动受限;7例为单发病灶,5例表现为相邻骨多发病灶。X线主要表现为斑片状低密度影或大块状、斑片状骨质溶解缺损;CT主要表现为大块状、斑片状的骨质溶解缺损,病灶残留骨端变细呈尖角样改变,部分病灶内可见残留骨/骨嵴、软组织肿块形成和邻近肌肉萎缩征象,增强扫描呈轻中度强化,静脉期呈持续性强化;MRI检查主要表现为T_(1)WI等/低/稍低信号,T_(2)WI稍高/高信号,增强后病灶明显强化,部分伴有周围软组织受侵表现;PET/CT检查表现为病变区域骨质氟代脱氧葡萄糖(FDG)摄取不均匀性增高;骨显像表现为受累骨放射性浓聚。结论 侵袭性血管瘤病罕见,其临床及实验室检查特点不显著,影像表现为单发/多发骨质溶解吸收,伴/不伴软组织肿块,周围软组织受侵表现,MRI增强呈明显强化,其中“大块骨质溶解”的影像特点有助于侵袭性血管瘤病的诊断。Objective To explore the clinical and imaging features of invasive angiomatosis and improve the recognition and early diagnosis of the disease.Methods The clinical data and imaging features of 12 patients diagnosed with invasive angiomatosis were retrospectively analyzed.Results Among the 12 cases,6 were male and 6 were female.Three patients had a history of local trauma at the lesion site,manifested as post-traumatic pain,two were found by physical examination,five were pain without obvious inducible cause,one was local tenderness,and one had limited movement.There were 7 cases with single lesions and 5 cases with multiple lesions of adjacent bone.X-ray mainly showed patchy low-density shadow or large block,patchy osteolysis defect.CT mainly showed large massive and patellar osteolysis defects,the residual bone end of the lesion became thin and turned into sharp angular changes,some lesions showed signs of residual bone/bone ridge,soft tissue mass formation,and adjacent muscle atrophy.The enhanced scan showed mild to moderate enhancement,and the venous phase showed continuous enhancement.MRI mainly showed equal/low/slightly low signal on T_(1WI) and slightly high/high signal on T_2WI.The lesions were significantly enhanced after enhancement,and some of them were accompanied by invasion of surrounding soft tissues.PET/CT examination showed increased uneven FDG uptake in bone in the lesion area.Bone imaging showed radioactive concentration of the affected bone.Conclusion Invasive angiomatos is rare,with no significant features in clinical and laboratory examination.The imaging manifestations are single/multiple osteolysis and absorption,with/without soft tissue mass,and surrounding soft tissue invasion,and MRI enhancement is significantly enhanced.The imaging features of “mass osteolysis” are helpful for the diagnosis of invasive angiomatosis.

关 键 词：侵袭性血管瘤病 影像表现 骨质溶解 

分 类 号：R73[医药卫生—肿瘤]