眼眶血管性肿瘤和畸形的超声及CT诊断

目的 探讨眼眶血管性肿瘤和畸形的超声(标准化A／B超)及CT检查诊断价值。方法 收集108例眼眶血管性病变患者的临床资料和超声(98例)及CT扫描(108例)图像进行回顾性分析,其中94例经手术及病理证实。海绵状血管瘤54例,静脉曲张26例,静脉性血管瘤13例,婴儿型血管瘤5例,淋巴管瘤6例,其他肿瘤4例。结果 超声检查肿瘤显示率达98％(96／98),假阴性率2％(2／98),术前定性确诊率为93％(91／98)。CT扫描的肿瘤显示率达100％(108／108),术前定性确诊率为92％(99／108)。结论 眼眶血管性肿瘤和畸形的超声检查与CT扫描联合应用对判断病变的性质、范围、位置及手术入路的选择至关重要。（中华眼科杂志,2004,40：364-367)     

Cavernous hemangioma of the left vocal cord

Laryngeal hemangioma in adults is a very rare condition. We report the case of a 41-year-old man with hemangioma of the left vocal cord. The literature on this rare occurrence is reviewed and the significance of the case discussed.     

内听道海绵状血管瘤(附1例报告并文献复习)

目的：探讨内听道海绵状血管瘤的诊断和治疗方法。方法：分析1例术后病理确诊为内听道海绵状血管瘤患者的临床表现、听力学、影像学及病理诊断等临床资料，并经扩大迷路进路行肿瘤切除术。结果：术后恢复良好，无面瘫、脑脊液漏等并发症发生，术后病理确诊为内听道海绵状血管瘤。结论：原发于内听道的海绵状血管瘤是一种极为罕见的内听道良性占位性血管性病变，和内听道其他常见的肿瘤如听神经瘤、面神经瘤等在临床表现、听力学及影像学上有许多相似之处，但也有其自身特点，确诊有赖于术后病理检查，结合临床表现和影像学（CT、MRI）特点，可为早期发现、选择合适的治疗方法提供信息。早期手术，其全切率及面、听神经功能的保存率较高。     

环境内分泌干扰物与婴儿皮肤血管瘤的关系

目的:研究探讨婴儿皮肤血管瘤与环境内分泌干扰物的关系。方法:采用气相色谱法检测160名皮肤血管瘤婴儿和160名正常对照婴儿头发环境内分泌干扰物水平。结果:皮肤血管瘤婴儿头发多氯联苯化合物(PCBs)水平明显高于正常对照婴儿。皮肤血管瘤婴儿组头发多氯联苯化合物检出率为95%,正常对照组婴儿检出率为37%,两组有显著差异(P<0.001)。结论:多氯联苯化合物在皮肤血管瘤患儿头发中的水平增高。     

Antiangiogenic therapy for a large splenic hemangioma

Hemangiomas involving the spleen are rare and seldom symptomatic. Treatment options for large lesions usually consist of splenectomy, embolization, or both. Antiangiogenic treatment has not been reported previously as an effective alternative for this type of lesion. We report our experience of successfully using glucocorticoids in an infant with a large hemangioma of the spleen.     

Management of cutaneous hemangiomas: a retrospective analysis of 1109 cases and comparison of conventional dose prednisolone with high-dose methylprednisolone therapy

The effectiveness of the different pharmacological agents and different doses of systemic cortico steroids was analyzed. A total of 1109 patients (median age 8 months; F/M: 2.3) with hemangioma, followed up in our unit for 23 years, were evaluated retrospectively. Forty-five of them received systemic corticosteroids. Two different pharmacological agents, prednisolone (in 26 patients) and methyl prednisolone (in 19 patients), had been used in three different regimens. Groups were compared according to the final results and rebound regrowth. Response was considered good or excellent in 16 patients (36%). There were no differences in response to therapy among the three regimens. No difference was found in response to therapy between prednisolone and methylprednisolone and the two different doses of the methylprednisolone. Rebound regrowth was significantly higher in methyl prednisolone than in the prednisolone group (p = .045). In multivariate analysis the dimension of the lesion (p = .0065) and age at initiation of treatment (p = .0041) were the most important factors affecting the response. In conclusion, the systemic corticosteroids are effective in 36% of patients, independent of dosage and pharmacological agents and duration of the therapy. The dimension of the lesion and age at initiation of treatment are the most important factors affecting the response to treatment.     

Cavernous hemangioma of the internal auditory canal

Hemangiomas rarely occur in the internal auditory canal. These tumors originate from the capillary bed of the epineurium surrounding the nerve and can either compress or infiltrate the nerve. Depending on location and the nerve of origin, these lesions can cause severe and progressive sensorineural hearing loss, tinnitus, facial nerve palsy, or vertigo even when they are relatively small. The presence of a small contrast-enhancing tumor in the internal auditory canal accompanied by severe sensorineural hearing loss and facial nerve palsy, should raise the suspicion of a hemangioma. Early recognition and surgical intervention in these benign tumors may improve the chance of preserving the functional integrity of the facial nerve and provides better results after nerve reconstruction. Due to their relative small size, the temporal bone CT-scan may show no evidence of pathological widening of the internal auditory canal or the typical intralesional calcifications at the time of presentation. MRI with Gadolinium is the imaging method of choice and a high index of clinical suspicion is necessary for the diagnosis of these tumors. In this paper we report about a 51-year-old male presented with right-sided sensory-neural deafness and facial nerve palsy, accompanied by severe tinnitus and ipsilateral loss of vestibular function due to a cavernous hemangioma in the internal auditory canal.     

Atypically enhancing hepatic cavernous hemangiomas: high-spatial-resolution gadolinium-enhanced triphasic dynamic gradient-recalled-echo imaging findings

We retrospectively investigated the appearance and frequency of atypically enhancing cavernous hemangiomas with high-spatial-resolution (512x224 matrix) gadolinium-enhanced triphasic dynamic gradient-recalled-echo (GRE) MR images. Images of 132 hepatic cavernous hemangiomas (ranging in size from 4 to 72 mm; mean size 17.2 mm) in 95 patients (42 men and 53 women; age range 25-85 years; mean age 54 years) were retrospectively reviewed by two independent radiologists. Forty (30%) of 132 lesions atypically enhanced. Smaller hemangiomas (< or =15 mm) more frequently (29%) showed early entire enhancement with or without arterio-portal shunting in the hepatic arterial-dominant phase ( p<0.001); most of them showed hyperintense complete fill-in in the equilibrium phase and were readily characterized. "Bright dot" or minimal peripheral enhancement in the equilibrium phase was seen in a small number of lesions (6% each). With T2-weighted images, 130 (98%) lesions showed moderately to very high signal intensity and only 2 (2%) with minimal peripheral enhancement showed hyperintensity of slight degree. The high-spatial-resolution dynamic GRE images clearly revealed minute enhancement characteristics of hemangiomas. Although moderately to very high signal intensity with T2-weighted MR images is informative for the diagnosis of most cavernous hemangiomas, when a lesion shows minimal peripheral enhancement in the equilibrium phase and hyperintensity of slight degree with T2-weighted images, further follow-up or biopsy may be warranted to discriminate hypovascular metastases.     

缺氧诱导因子-1α在婴幼儿血管瘤及血管畸形中的表达与意义

目的 本研究拟通过检测缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、细胞增殖核抗原Ki-67、血管内皮标志抗原CD34在婴幼儿血管瘤不同时期、血管畸形和儿童正常皮肤中的表达,探讨缺氧在血管瘤血管生成、细胞增殖中的作用.方法 采用免疫组织化学S-P染色法,检测CD34、HIF-1α、VEGF和Ki-67在小儿血管瘤、血管畸形及正常皮肤组织中的表达,并计算微血管密度(MVD).结果 不同时期血管瘤之间,血管瘤与血管畸形、正常皮肤之间HIF-1α、VEGF、Ki-67、MVD均有显著性差异(P<0.05).血管瘤中HIF-1α表达分别与VEGF、Ki-67、MVD表达呈正相关;而血管畸形HIF-1α与VEGF表达不存在相关关系.结论 缺氧是不同时期血管瘤的普遍现象.HIF-1α能促进血管瘤血管生成.而在血管畸形中可能不存在缺氧的微环境,是"血管内皮细胞生长正常的血管形态异常",因此在血管畸形中不会发生内皮细胞的增殖,也不存在类似血管瘤那样出现增生期和消退期.     

单核细胞趋化蛋白-1和血管内皮细胞生长因子在人皮肤血管瘤中的表达及其相关性

目的:探讨单核细胞趋化蛋白-1(MCP-1)和血管内皮细胞生长因子(VEGF)在人皮肤血管瘤发生、发展及退化过程中的表达及其相关性。方法:采用免疫组化方法(SP法)和计算机图像分析技术,检测人皮肤血管瘤增生期、消退期及正常皮肤中的MCP-1、VEGF的平均阳性面积率和平均光密度。结果:增生期血管瘤与消退期血管瘤、正常皮肤组分别相比,MCP-1、VEGF阳性表达的平均光密度和平均阳性面积率有显著性差异(P<0.05);消退期血管瘤与正常皮肤组之间,MCP-1、VEGF阳性表达率无显著性差异(P>0.05);MCP-1、VEGF阳性面积表达率呈明显的正相关(r=0.746,P<0.05)。结论:MCP-1、VEGF在人皮肤血管瘤过度增生中起着重要的作用,且二者之间可能具有相互协同作用。