韧带样型纤维瘤病的超声图像及病理基础

目的通过总结韧带样型纤维瘤病（DF）的超声图像表现和病理学结构，以提高对DF的认识和诊断水平。方法回顾性分析2005年1月-2011年12月70例经手术和病理组织学证实为DF患者的超声图像和病理组织学结果。结果DF肿块的超声表现与病理结构密切相关。70例DF中腹部外型41例（58．6％）、腹壁型18例（25．7％）、腹内型11例（15．7％）。DF的典型超声图像表现为沿肌纤维浸润性生长的低回声肿块，累及多块肌肉；肿块无包膜，多数形态不规则、边界不清；其中8例包绕和侵犯相邻骨质，12例肿瘤压迫或侵犯邻近血管、神经、肠管等组织；40例瘤体内探及I级血流信号，4例探及Ⅲ级血流信号；所有病变均未见坏死出血和囊变，病变周围无淋巴结肿大。结论DF的声像图表现有较强的特征性，超声能较为准确判断肿块累及范围、是否侵犯相邻骨质、与毗邻血管、神经的关系，有助于制定手术计划。

Ultrasonic Imaging and Pathologic Basis of Desmoid-type Fibromatosis

Objective To summarize and analyze the ultrasonographic features and pathological structures of desmoid-type fibromatosis(DF),in order to improve the recognition and diagnosis of the disease.Methods We retrospectively analyzed the ultrasonic images and pathological results of 70 patients diagnosed to have DF pathologically and surgically and treated between January 2005 and December 2011.Results The ultrasound manifestations of DF was closely related to it’s pathological structures.Of the 70 cases,41 were extra-abdominal desmoid tumors(58.6%),18 were abdominal wall desmoid tumors(25.7%),and 11 were intra-abdominal desmoid tumors(15.7%).On ultrasonography,desmoid tumors were characterized by an invasive growth along the muscle fibers involving the muscles;the tumors were generally hypoechoic with ill-defined margins,irregular shape and no envelope.The lesions surrounded and infiltrated adjacent bones in 8 cases,and oppressed or violated adjacent vessels,nerves and intestine in 12 cases.Color doplor flow imaging showed grade-Ⅰ flow of masses in 40 cases and grade-Ⅲ flow in 3 cases.However,all the tumors were generally not accompanied by necrosis,hemorrhage,cystic change or lymphonodus enlargement.Conclusions The ultrasonographic appearances of DF have typical features.It’s results can guide to make operation plan based on understanding the extent of lesions and its relationship with other surrounding structures.