淋巴管畸形的高频超声与彩色多普勒特点

目的 研究淋巴管畸形的高频超声及彩色多普勒超声表现特点并进行分析、总结.方法 应用高频超声及彩色多普勒超声对23例淋巴管畸形的二维灰阶超声声像图及彩色血流信号进行回顾性研究.超声扫查内容包括:病变大小、边界、内部回声、彩色血流信号及用脉冲多普勒测量血流速度.结果 17例淋巴管畸形(74%,17/23)位于颈部、颌下或腋下,6例位于其他部位;21例位于皮下组织内,其中3例同时累及真皮及肌层.13例大囊型淋巴管畸型,均显示为较大的无回声区,有分隔,壁光滑,其中2例大囊型合并感染,无回声区内有稀疏低回声;5例混合型淋巴管畸形,为淋巴管畸形和血管畸形混合存在,超声显示为大小不等的无回声区有分隔,合并局部微小无回声区或不规则的小的实性低回声区,其中3例侵及肌层;5例微囊型淋巴管畸形,超声显示以无回声区为主,内有少量的低回声区,形成囊实混合性病变.所有病例无回声区内彩色多普勒扫查均无彩色血流信号.8例大囊型及3例混合型淋巴管畸形周边扫查到彩色血流信号,2例微囊型内部实性低回声内显示有彩色血流信号.脉冲多普勒检查最大血流速度18～73 cm/s,阻力指数0.55～0.72.结论 淋巴管畸形的高频超声及彩色超声多普勒成像有显著的特点,以较大的无回声区为主,多发可有分隔,无回声区内无血流信号,大部分位于皮下组织内,基于以上特点,可确诊大部分病例,因而高频超声及彩色多普勒是诊断淋巴管畸形的较好方法.

High-resolution color Doppler ultrasonographic characteritics of lymphatic malformations

Objective To analyse the characteristics and diagnostic value of high-resolution grayscale and color Doppler ultrasound in lymphatic malformations. Methods Twenty-three lymphatic malformations were evaluated by 7-12 MHz high-resolution grayscale and eolor Doppler ultrasound. All the cases were comfirmed by histopathologic diagnosis. The size, location, margin, echo pattern and the color Doppler blood flow signal were observed. Pulsed Doppler was used to measure the blood flow velocities and distinguish arteries from veins. Results Seventeen lesions （74% , 17/23 ） located in neck, submaxillary or subaxillary. Twenty-one were detected subcastaneously,3 of them in both subcastaneous and muscular layer. Thirteen cases of macrocystic lymphatic malformation appeared as a large, multi-septation, nonechogenic cyst. Two cases of recurrent infections showed as echogenic debris in nonechogenic cysts. Five cases of combined type, which were capillary-lymphatic malformations appeared as muhi-septation, large or tiny nonechogenic cysts, with or without local hypoechoic solid areas. Five patients had microcystic lymphatic malformation, high-resolution grayscale ultrasound showed tiny vesicles as solid hypoechoginic areas with large and tiny echo-free cysts. Blood/low signal were only detected in the peripheral area of cysts or within the solid area of the lesions. Peak arterial flow velocity ranged from 18 to 73 cm/s, resistive index ranged from 0. 55 to 0. 72. Conclusion Nonechogenic and multi-septational large cysts, locating in neck, submaxilllary or subaxillary with few color flow signal were distinctive uhrasonographic characteristics of macrocystie or mixed type lymphatic malformations. High-resolution grayscale and color Doppler ultrasound is valuable in the diagnosis of lymphatic malformations .