血管瘤与脉管畸形的鉴别诊断研究进展

血管瘤和脉管畸形是婴幼儿比较常见的血管疾病,过去由于对两者的分类和诊断比较混乱,给临床治疗带来诸多不便,也给患者增加了不必要的痛苦。1982年,Mulliken和Glowacki提出了脉管性疾病的生物学新分类,将血管瘤和脉管畸形归类为2种性质完全不同的病变。血管瘤是多发于婴幼儿的良性肿瘤,大多数可以自行消退;而脉管畸形是血管结构的发育异常,不会自行消退,随患者的生长发育持续增长。因此,对于确诊的脉管畸形,应尽早采取干预措施。这就要求临床医师能及时、准确、有效地鉴别诊断血管瘤和脉管畸形。本文就目前关于血管瘤和脉管畸形的鉴别诊断进展作一综述。

Diagnosis of hemangiomas and vascular malformations: An overview

Hemangiomas and vascular malformations are the most common vascular lesions in infants and children. In the past years, due to the lack of definite classification and distinctions of vascular lesions, misdiagnosis and mismanagement were often encountered and the patients underwent inappropriate treatment. A renaissance began with the biological classification proposed by Mulliken and Glowacki in 1982. They categorized vascular lesions into hemangiomas and vascular malformations, which were absolutely different both clinically and biologically. Hemangiomas are benign tumors of infancy that have a proliferation phase followed by subsequent involution throughout childhood. Vascular malformations result from errors of vascular morphogenesis, they grow commensurate with the patient throughout life and never involute. From a prognostic standpoint, vascular malformations may need intervention as early as possible. So we must differentiate hemangiomas from vascular malformations early and accurately. In this review, we summarize the highlights of the diagnosis between hemangiomas and vascular malformations. Supported by Shanghai Leading Academic Discipline Project(Grant No.Y0203).