浅表软组织肿块的超声检查评价

Ultrasonographic Features of Superficial Soft Tissue Masses

目的 探讨二维高频超声及彩色多普勒超声对浅表软组织肿块的诊断价值。方法 对 1 2 1例浅表软组织肿块应用二维高频超声及彩色多普勒超声进行检查和分析。全部病例均经手术和病理学检查证实。结果 良性肿块 1 0 2例 (其中脂肪瘤 6 5例 ,腱鞘囊肿 1 2例 ,神经鞘瘤 7例 ,神经纤维瘤 2例 ,血管瘤 8例 ,结核脓肿 5例 ,内膜移位 1例 )。恶性肿块 1 9例 (其中恶性神经鞘瘤 5例 ,恶性纤维组织细胞瘤 4例 ,隆突性皮肤纤维肉瘤 4例 ,脂肪肉瘤 4例 ,恶性颗粒细胞瘤 1例 ,横纹肌肉瘤 1例 )。良性肿块中边界不清者 4 0例 (39% ) ,圆度系数 >2 .0者 5 9例 (5 7.8% ) ,内部回声多半分布均匀 ,彩色血流检出率 2 0 .5 8%。恶性肿块边界清晰者 1 0例 (5 2 .6 % ) ,圆度系数<1 .5者 1 2例 (6 3.1 % ) ,内部回声多半不均匀 ,彩色血流检出率 1 0 0 %。结论 二维高频和彩色多普勒超声有助于确定浅表软组织肿块的形态、大小及深度 ,区分肿块的囊实性与血流特征 。

Objective To evaluate the value of two-dimensional hign frequency and color Doppler ultrasonography in the diagnosis of superficial soft tissue masses Methods A total of 121 patients with superficial soft tissue masses were examined and analyzed with two-dimensional high frequency and color Doppler ultrasonography All of the patients were verified by operation and pathological examination Results A total of 102 cases were proved as benigh masses Among them,lipoma was in 65 cases,ganglions in 14 cases,hemangioms(8 cases),neurilemoma (7cases),neurinoma (2 cases),tuberculosis abscess (5 cases) and endometriosis (1 case).Ninteen cases were proved as malignant masses,among them malignant neurilemoma was (in 5 cases),malignant fibr-ohisliocytoma (5 cases),liposarcoma (4 cases),fibro sarcoma (4 cases) and malignant gradulocytoma (1 case) and rhabdomyosarcoma(1 case) The boundaries of the masses were hardly defined in 40 benign cases (39%) and the roundness index was > 2 in 59 cases of benign lesions The detective rate of color flow signals was 20 58% in benign lesions whereas the boundaries were clearly defined in 10 malignant cases The roundness index was < 1 5 in 12 cases (63 1%) The echogenicity was heterogeneous in distribution in the most of malignant lesions The color flow detective rate was 100% Conclusions Two-dimensional high frequency and color Doppler ultrasongraphy is helpful not only to determine the morphology,size and depth of the superficial soft tissue masses but also to differenciate the cystic from solid echotexutre and to demonstrate the vasculature pattern of the masses Therefore,it is valuable in the clinical application