摘要
目的探讨侵袭性血管黏液瘤(AA)及浅表型血管黏液瘤(SA)的临床及影像学表现。方法回顾性分析本院病理证实AA 8例及SA 1例的影像学资料,女性7例,男性2例,年龄23~57岁,其中6例超声、8例CT、7例MRI、1例PETCT,分别描述病灶大小、质地、形态、强化方式等并进行分析探讨。结果 5例病灶〉10 cm;B超呈不均匀偏低/低回声6例;CT平扫呈不均匀低/等低密度影8例,增强扫描表现不均匀逐渐强化3例,分层漩涡征2例,灶内含小血管影4例;MRI T2WI呈高/略高信号6例,其中分层漩涡卷云征3例;增强后逐渐持续强化7例,分层漩涡征3例,2例时间-信号动态曲线(TDC)为缓升型;1例18F-FDG-PETCT示低浓聚摄取。结论本病女性多见,超声为低回声或囊实性;CT增强后具有小血管影和/或分层漩涡征的不均匀逐渐强化灶;MRI亦为逐渐强化,T2WI及增强后显示特征性分层漩涡征,PETCT低摄取,这些特点有助于正确诊断。
Objective To retrospectively analyze the clinical and imaging manifestations of aggressive angiomyxoma and superficial angiomyxoma. Methods Eight patients with pathologically proved aggressive angiomyxoma and one patient with pathologically proved superficial angiomyxoma were collected for analysis. Imaging examinations included ultrasonography ( n = 6), CT scan ( n = 8), MRI ( n = 7) and PET-CT ( n = 1 ). The imaging findings, focusing on the lesion' s size, texture, shape and enhancement pattern, were analyzed. Results The patients included 7 females and 2 males, with the age of 23 -57 years old. In five patients the diameter of lesion was 〉 10 cm. Uhrasonography demonstrated that the lesion was characterized by inhomogeneous slightly-low or low echo area in 6 patients. Plain CT scan showed that the lesion pres- ented as inhomogeneous low-density or iso-density shadow in 8 patients; and the lesion showed gradual inhomogeneous en- hancement in 3 patients; "layered whirlpool" sign was observed in 2 patients and small vessels shadow within the lesion was seen in 4 patients. The lesion was high or slightly higher signal on T2WI ( n = 6) with "stratified swirl cirrus" sign ( n = 3 ) ; contrast-enhanced scan showed that the lesion was gradually and continually enhanced ( n = 8 ) with "layered whirl- pool" sign ( n = 3 ). Time-intensity dynamic curve of slow-rising type was seen in 2 patients. ~SF-FDG-PETCT revealed low FDG uptake in one patient. Conclusion Clinically, angiomyxoma mainly occurs in the female pelvis. The lesion is low- echo and cystic-solid mass. On enhanced CT scan, small vessels shadow within the lesion and "layered whirlpool" sign with inhomogeneous gradual enhancement can be observed. On MRI, the lesion shows gradual enhancement and character- istic "layered whirlpool" sign. Low FDG uptake can be found in PET-CT examination. All the above mentioned features are helpful for a correct diagnosis.
出处
《临床放射学杂志》
CSCD
北大核心
2015年第5期784-788,共5页
Journal of Clinical Radiology
关键词
血管黏液瘤
侵袭性
浅表性
成像
计算机
断层扫描
磁共振成像
超声
Angiomyxoma Aggressive Superficial Imaging Computed tomography Magnetic resonance imaging Ultrasound