浅表脂肪瘤的超声分型及与病理对照的研究

Study of ultrasonic typing and pathological comparison in superficial lipoma

目的分析浅表部位脂肪瘤的声像图特点，探讨超声对其诊断价值。方法超声检查620例浅表部位脂肪瘤患者，观察肿块数量、部位、形态、大小、边界、内部回声、毗邻关系、距皮肤深度、是否在脂肪层内等，同时观察包块内部及周边的血流分布，分析肿块的超声表现与病理组织学分型的相关性。结果典型的脂肪瘤380例，超声表现为边界清楚，包膜高回声，肿块内部呈低回声，与周围脂肪回声相似，问有纤细的条纹状高回声分隔；病理组织学表现为大量成熟的脂肪细胞。高回声脂肪瘤175例，超声表现为肿块呈高回声，明显高于周边脂肪组织回声，分界清楚，但无包膜，内部回声较均匀；镜下可见脂肪细胞及毛细血管和纤维组织。非典型脂肪瘤65例。结论浅表脂肪瘤的超声分型，有助于其诊断。

Objective To analyze the sonogram features of superficial lipoma, and to explore the diagnostic value by ultrasound. Methods Six hundred and twenty patients with superficial lipoma were examined by ultrasonography. Their quantity, position, shape, size, border, internal echo, adjacent relations, depth from the skin and whether in fat layer were observed. And the condition of masses interior and blood flow distribution were observed at the same time. The correlation of ultrasonic appearance and pathologic histology typing of the masses were analyzed. Results Three hundred and eighty cases of typical lipoma were confirmed by ultrasonography, their appearance was clear boundary with peplos high level echo, low level echo in masses similar to the surrounding fat echo, and slender barred high level separated fight pattern. The appearance of pathologic histology was abundant ripe fat cells. There were 175 cases of high level echo lipoma, the ultrasonic appearance was high level echo masses which was significant higher than surrounding fat echo, clear boundary without peplos. Internal echo was uniform. Pathologic histology showed fat cells, capillaries and fibrous tissue, the rest were atypical lipoma. Conclusion The ultrasonic appearance of superficial lipoma has some characteristics. Ultrasonic typing of lipoma has important value in imaging basis and diagnosis of superficial lipoma.