汗孔瘤的高频超声声像图特征及误诊原因分析

Analysis of the Characteristics of High Frequency Ultrasonography and the Cause of Misdiagnosis of Poroma

目的探讨汗孔瘤的高频超声声像图特征及高频超声对汗孔瘤的诊断价值。方法回顾性分析8例经手术病理证实的汗孔瘤的高频超声声像图表现,总结其声像图特征,分析误诊原因。结果汗孔瘤高频超声声像图表现为表皮层及真皮层肿物,大者可突出至皮下组织内,单发(100%)、边界清晰(100%)、形态较规则(75%)或呈不规则分叶状(25%),内部为实性低回声(62.5%)或囊实性(37.5%),部分可见多发点状强回声(25%)。彩色多普勒可见较丰富血流信号(50%)或少量血流信号(50%),超声误诊率为62.5%(其中2例误诊为钙化上皮瘤,1例误诊为血管瘤,1例误诊为软纤维瘤,1例误诊为炎性病变)。结论汗孔瘤的声像图有一定特点,但缺乏特异性,超声可对累及的解剖层次进行精确定位,并可显示肿物内部的回声特点、血供特征及其与周围组织的毗邻关系,指导治疗方案的选择,亦可作为术后随访的评估手段。

Objective To investigate the characteristics of high frequency ultrasonography and the to diagnostic value of high-frequency ultrasonography in poroma.Methods The ultrasonographic features of 8 cases of poroma confirmed by surgery and pathology were analyzed retrospectively.The ultrasonographic features were summarized,and the causes of misdiagnosis were analyzed.Results The high-frequency ultrasonographic features of poroma were located in epidermis and dermis.The larger could protrude into subcutaneous tissue,with single(100%),clear boundary(100%),regular shape(75%)or irregular lobulation(25%),solid hypoechoic(62.5%)or cystic solid mix(37.5%),and multiple punctate hyperechoic(25%).Color Doppler showed abundant blood flow signal(50%)or a small amount of blood flow signal(50%).The misdiagnosis rate of ultrasound was 62.5%(including 2 cases misdiagnosed as calcified epithelioma,1 case misdiagnosed as hemangioma,1 case misdiagnosed as soft fibroma and 1 case misdiagnosed as inflammatory lesion).Conclusion The sonographic of poroma has certain characteristics,but lacks specificity.Ultrasound can accurately locate the involved anatomic level of the tumor,and show the internal echo characteristics,blood supply characteristics and involved situation of the surrounding tissue,which can guide the choice of treatment plan.It can also be used as the evaluation method of postoperative follow-up.