瘤样钙盐沉着症的超声表现

Ultrasonographic Manifestations of Tumoral Calcinosis

目的探讨瘤样钙盐沉着症的临床及超声表现。资料与方法回顾性分析2016年1月—2022年5月四川省人民医院经手术病理证实的44例瘤样钙盐沉着症患者的临床及超声资料,总结临床表现(年龄、性别、压痛、质地、皮肤改变、血磷、碱性磷酸酶、血钙)及超声表现(病变部位、大小、内部回声、边界、后方声影、与周围结构的关系、血流信号)。结果44例瘤样钙盐沉着症患者共47个病灶,17个病灶位于臀部,9个病灶位于肢体,33个病灶呈无痛性包块。44例患者血钙及碱性磷酸酶均正常,5例血磷升高。瘤样钙盐沉着症主要位于皮肤层、脂肪层或肌层内,不累及骨质。瘤样钙盐沉着症的超声表现分为3型,①结节状钙化灶堆积型:41个(87.23%)病灶表现为沙粒样或颗粒状钙化灶堆积呈结节状,所有结节后方均伴有声影,其中8个病灶边界较清楚,周边可见细窄的低回声带,内未见明显血流信号,10个病灶周边见较宽的低回声带,边界可辨,血流信号较丰富;②囊性团块伴钙化灶沉积型:4个(8.51%)病灶表现为囊性团块,内可见分隔,囊壁及分隔多发细沙样或颗粒样钙化灶沉积伴声影,囊性团块边界不清晰,囊壁可见稀疏血流信号;③孤立粗大钙化灶型:2个(4.26%)病灶表现为孤立粗大钙化灶,后方伴宽大声影,边界较清晰,未见明显血流信号。结论瘤样钙盐沉着症的临床及超声表现具有特征性,多呈无痛性质硬包块,超声表现分为3型,病灶位于软组织内,不累及骨质。

Purpose To explore the clinical and ultrasonographic manifestations of tumoral calcinosis(TC).Materials and Methods A total of 44 patients who had both preoperative ultrasonographic evaluation and pathological diagnosis of TC were enrolled in Sichuan Provincial People’s Hospital from January 2016 to May 2022.Clinical data(age,gender,serum phosphate,serum alkaline phosphatase,serum calcium,tenderness)and ultrasonographic manifestations(lesion location,size,internal echogenicity,relationship with surrounding structures,blood flow signals)of each lesion were all described.Results There were 47 lesions in 44 patients with tumoral calcinosis,17 lesions were located on the buttocks,9 lesions were located in the limbs,and 33 lesions were painless masses.Serum calcium and alkaline phosphatase were normal in 44 patients,while serum phosphorus was elevated in 5 patients.Calcinosis neoplasm was mainly located in the skin layer,fat layer or muscle layer,and did not involve bone.The ultrasonographic manifestations of tumoral calcinosis were divided into three types:①nodular calcification accumulation type:41 lesions(87.23%)showed sandlike or granular calcification with nodular accumulation,and all nodules were accompanied by sound shadows.8 lesions had clear boundaries with narrow low gyrus vocal cords around them,and no obvious blood flow signal was observed;10 lesions had wide low gyrus vocal cords around them,and the boundaries were recognizable,and blood flow signal was abundant.②Cystic mass with calcification foci deposition type:4 lesions(8.51%)showed cystic mass with internal separation,cyst wall and separated multiple fine sand or granular calcification foci deposition with sound shadow,cystic mass boundary was not clear,and sparse blood flow signal was seen in the cyst wall.③Isolated coarse calcification foci:two foci(4.26%)showed isolated coarse calcification foci with wide loud shadow behind,clear boundary and no obvious blood flow signal.Conclusion Characteristic clinical and ultrasonogrphic manifestations are found in patients with TC.TC generally presents as a painless mass located in dermal,fatty and muscular layer in young people and mainly demonstrated three types without osseous involvement on ultrasonography.