乳腺型肌纤维母细胞瘤的超声特征

Ultrasonic features of extramammary myofibroblastoma

目的分析乳腺型肌纤维母细胞瘤(MFB)的超声图像特征。方法回顾性分析2014年10月~2020年5月四川大学华西医院手术病理证实的7例乳腺型肌纤维母细胞瘤超声声像图特征。结果7例MFB患者均为单发肿块,男性5例,女性2例,年龄6~68岁,平均最大直径(50.86±15.56)mm;5例位于腹股沟区皮下层,2例位于盆腔内,且与膀胱及髂血管紧贴;5例位于身体左侧,2例位于身体右侧。灰阶超声所有肿块均表现为边界清楚、形态欠规则、不均质弱回声团块,发生在腹股沟者比盆腔内者弱回声程度更低;仅1例发生在腹股沟者内探及多数点状钙化;发生在盆腔者体积更大。彩色多普勒超声(CDFI)示5例肿块内探及点线状血流信号,较丰富,2例肿块内未见明显血流信号。7例患者均未出现复发及转移。结论MFB发生于浅表软组织者超声表现为单发、边界清楚、形态欠规则的不均质弱回声团块,团块内探及点线状血流信号;发生于深部脏器者除了体积更大,未见明显血流外,其余超声特征与浅表软组织者未见明显差异。两种类型均无复发及转移;术前定性诊断较困难,必要时仍需结合病理活检来明确诊断。

Objective This study investigated the sonographic features of extramammary myofibroblastomat(MFB).Methods The ultrasonographic findings of 7 patients of MFB confirmed by pathology were retrospectively analyzed.Results All the 7 patients showed a single mass.There were 5 males and 2 females.The age of 7 patients ranged from 6 to 68 years old.Average maximum diameter was 50.86±15.56mm,5 of the tumors located at the subcutaneous layer of the inguinal region,2 located at the pelvic cavity,which was close to the bladder and iliac vessels.The tumors were located on the left side of the body in 5 cases and on the right side in 2 cases.The gray-scale ultrasonography of all the masses showed circumscribed margin,irregular shape,heterogenous hypoechoic mass.The degree of hypoechoic echo is lower in the inguinal region than in the pelvic cavity.Only 1 case of microcalcification was found in the inguinal region.The pelvic mass was larger.CDFI showed that blood flow signals of all inguinal masses were dotted and linear.There was no obvious blood flow signal in the pelvic mass.No recurrence or metastasis occurred in all patients.Conclusion MFB mostly occurs in middle-aged and elderly male patients.Ultrasound manifestations of MFB in superficial soft tissue are single,circumscribed margin,irregular and heterogenous hypoechoic mass,and blood flow signals were dotted and linear.In addition to the larger volume and no obvious blood flow,there was no significant difference in the ultrasonographic features between the superficial soft tissue and the cases of deep organs,there was no recurrence or metastasis in the two types.Preoperative diagnosis is sometimes difficult,and pathological biopsy is still needed to confirm the diagnosis when it is necessary.