脂肪母细胞瘤的临床及超声声像图分析  

Clinical manifestation and ultrasonic analysis of lipoblastoma

作　　者：杨裕佳[1] 唐远姣[1] 冷钱英 向茜[1] 张凌燕[1] 邱逦[1] 

机构地区：[1]四川大学华西医院超声科,四川成都610041

出　　处：《肿瘤影像学》2015年第2期99-103,共5页Oncoradiology

基　　金：国家自然科学基金(81271585)

摘　　要：目的:回顾分析脂肪母细胞瘤的临床和超声表现特征。方法:回顾性分析四川大学华西医院46例脂肪母细胞瘤患者的资料,分析总结该病的临床与超声表现特征。结果:46例患者中,年龄≤3岁者35例(76%)。包块均为单发、无触痛;包块质软或质中39例(85%),活动良好或较好41例(89%)。包块位于皮下26例(57%)、肌层14例(30%)、皮下及肌层均受累2例(4%)、腹膜后或系膜上4例(9%)。包块最大径≥3.0 cm41例(89%)。包块表现为稍高回声33例(72%)、低回声11例(24%)、杂乱回声2例(4%)。包块边界清楚35例(76%),形态规则35例(76%),内部可见线状、条索状强回声分隔36例(78%),包块内出现钙化1例,裂隙状弱回声者1例。肿块内部血流信号Adler分级:0级20例(43%)、Ⅰ级23例(50%)、Ⅱ级3例(7%)。比较脂肪母细胞瘤弥漫型(10例)与局限型(36例),发现质地、活动度、部位、大小、形态、内部强回声分隔差异均有统计学意义(P<0.05)。结论:脂肪母细胞瘤临床和超声表现有一定特点,好发于3岁以下婴幼儿,均单发,包块多质软或质中,活动良好或较好。声像图特征为包块多位于皮下,最长径>3 cm,多为内部伴有强回声分隔的稍高回声团块,边界清楚,形态规则,半数以上可见Ⅰ级或Ⅱ级血流信号。弥漫型脂肪母细胞瘤较局限型质硬,多位于肌层,最长径>6 cm,形态不规则,内部无强回声分隔。Objective: To review and analyze the clinical and ultrasonic features of lipoblastoma. Methods: A total of 46 cases with pathologically proved lipoblastoma in our hospital were selected. The data including clinical characteristics, ultrasonic images and pathologic results were retrospectively analyzed. Results: Age: 35 cases were less than or equal to 3 years old(76%). Physical examination: All lesions were single and painless soft tissue masses, among which 39(85%) were soft or moderate, and 41(89%) had good or preferable mobility. Location and size: 26 lesions were located in subcutaneous soft tissue(57%), 14 in muscle(30%), 2(4%) in both subcutaneous soft tissue and muscle, and 4(4%) in retroperitoneum or mesenterium. The tumor size in most cases(89%) were greater than or equal to 3 cm. Pattern of echogenicity: 33 lesions were hyperechoic(72%), 11(24%) were hypoechoic and 2 were heterogeneous. Linear or cord-like separations with strong echo were found in 36 lesions(78%). 1 case had calcification in the mass and 1 case had slit-shaped weak echo. Boundary and shape: 35 cases(75%) had clear boundary and regular shape. Blood supply: According to Adler semi-quantitative classification standards, 20 lesions(43%) were grouped into grade 0, 23(50%) into grade Ⅰ and 3(7%) into grade Ⅱ. All lesions could be grouped into diffuse type(36 cases) and localization type(10 cases). The hardness, mobility, location, size, shape and inner hyperechoic separation of lesions between the two types were significantly different(P<0.05). Conclusion: The typical clinical characteristics of lipoblastoma are as follows: Most patients are infants. All lesions are single soft tissue masses. Most lesions are soft or moderate, and have good or preferable mobility. The typical ultrasonic characteristics of lipoblastoma are large hyperechoic subcutaneous mass with strong echoic seperations, regular shape and clear boundary. More than half of them have grade Ⅰ or grade Ⅱ blood supply according to Adler semi-quantitative classification s

关 键 词：脂肪母细胞瘤 超声检查 彩色多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R738.6[医药卫生—诊断学]