手足部软组织血管瘤3.0T MRI检查及临床价值

Hemangiomas of hands and feet:3.0T MRI examination and clinical evaluation

目的探讨3.0T的超高场强MRI检查对手足部血管瘤的临床价值。方法25例手足部血管瘤病例进行了3.0TMRI检查的平扫、增强磁共振血管成像(CEMRA)以及增强各向同性三维(3D)容积成像,回顾性分析病变MRI诊断和范围评价,并与手术病理结果对照。结果25例中海绵状血管瘤16例,蔓状血管瘤4例,毛细血管瘤2例,混合脉管瘤3例。MRI常规平扫结合增强扫描均能准确诊断。MRI显示病变累及皮下脂肪及肌间隙23例,肌肉17例,肌腱14例,均与手术病理对照相符;手术中显示骨皮质受累共6例,MRI显示4例;手术中显示神经受累5例,MRI均未能显示。CEMRA的动脉期显示供血动脉轻度增粗10例,与手术所见相符,静脉期显示病变染色9例。结论3.0TMRI能够对手足部血管瘤进行准确的术前诊断和全面评价。

Objective To study the 3.0T MRI examination and clinical value of hemangiomas of hands and feet. Methods Twenty-five patients with hemangioma of hands or feet underwent 3.0T MRI with plain scan, CEMRA, isotropic three dimensional contrast enhancement. The imaging diagnosis and evaluation of the extent of the lesions were analyzed retrospectively and correlated with patho-surgery. Results Surgical pathological results were cavernous hemangioma（16/25）, racemosum hemangioma（4/25）, capillary hemangioma（2/25） and combine vascular tumor （3/25）. All cases were diagnosed accurately with plain scan and contrast enhancement. Correlated with the results of surgery and pathology, MRI demonstrated all the involvement of subcutaneous fat and spatium intermuseulare（23/25）, muscle（17/25）, muscle tendon（14/25）. Four bone-involved cases demonstrated by MRI were proved by surgery. Five nerve-involved eases were proved in surgery and none of them demonstrated in MRI. CEMRA demonstated enlarge feeding vessels in arterial phase（lO/25） which were correlated with surgery, and stained in venous phase. Conclusion Hemangiomas of hands and feet can be diagnosed accurately and overall evaluated with 3.0T MRI.