软组织血管瘤的影像诊断

目的:研究软组织血管瘤的X线平片、CT 和MRI 征象,探讨CT 和MRI对该肿瘤的诊断价值。方法:对经手术病理或临床确诊的软组织血管瘤35例进行回顾性分析。所有病例均行X线平片、CT平扫和增强扫描。其中动态增强扫描8例,MRI检查15例。结果:海绵状血管瘤19例,蔓状血管瘤8例,毛细血管瘤3例,混合型血管瘤2 例,血管瘤病3例。CT平扫肿瘤呈结节状、分叶状、管状或团块状低密度病变。增强扫描后血管成分显著强化,可呈扭曲血管状,而非血管成分不强化或轻度强化。MRIT1WI上肿瘤呈略高信号或等信号,T2WI上呈显著高信号,其中夹杂不均匀信号,病理上代表了脂肪、纤维组织、平滑肌、血栓、静脉石和钙化。结论:CT和MRI对血管瘤均可作出定性诊断,但MRI在显示血管瘤内特征性的血管及血管成分间的脂肪纤维组织方面较CT优越。

Imaging diagnosis of soft tissue hemangiomas

OBJECTIVE:To study the X-ray plain film,CT and MRI findings of soft tissue hemangiomas with emphasis on CT and MRI value in the diagnosis of soft tissue hemangiomas. METHODS: Thirty-five cases of soft tissue hemangiomas proved by surgical-pathological or clinical data were analysed retrospectively. X-ray plain film, plain scan CT and enhancement CT were performed in all cases, and MRI in 15 cases. Dynamic contrast enhancement CT was performed in 8 cases.RESULTS: Hemangiomas included cavernous (n=19), capillary (n=3),tufted (n=8), mixed (n=2) and angiomasis (n=3). X-ray plain film showed plebolith or calcification in 12 cases. All tumors in plain scan CT were tubercular,lobular,tubular or mass low-density lesions.The vascular component within the tumor displayed markedly enhancement,and sometimes serpentine vessels,while the non-vascular tissues showed no or lightly enhancement after intravenous contrast injection.MRI findings were slightly high signal or intermediate on T 1WI and extremely bright signal intensity on T 2WI. Focal inhomogeneities of the lesions in pathological study represented areas of fat, fibrosis, smooth muscle,thrombosis, plebolith or calcification.CONCLUSIONS: An qualitative diagnosis for hemangioma can be made by CT or MRI,but MRI is superior to CT in displaying the characteristic vascular and fibrofatty structure inside the lesion.