摘要
目的探讨和评估先天性血管瘤(congenital hemangioma,CH)、婴幼儿血管瘤(infantile hemangioma,IH)二维和三维超声影像学特点及意义。方法对2015年12月至2019年1月在上海交通大学医学院附属第九人民医院超声诊断科进行超声检查,并经临床随访(6个月至2年),或病理诊断证实的IH和CH患儿首诊时的超声检查资料进行回顾性分析,包括病灶厚度、回声、边界、血管密度、三维超声形态。采用Student’s t检验比较CH与IH病灶的超声数据测量值,方差分析不同类型CH的超声回声特点,K-W检验和χ2检验比较CH与IH的超声回声特点,P<0.05表示差异有统计学意义。结果共有93例CH和94例IH患儿纳入该研究。93例CH中男59例,女34例,年龄5 d至3岁,其中快速消退型(rapid involuting congenital hemangioma,RICH)30例,不消退型(non-involuting congenital hemangioma,NICH)42例,部分消退型(partial involuting congenital hemangioma,PICH)21例;94例IH共98处病灶,男22例,女72例,年龄1个月至1岁,其中有4例为多发。CH病灶最大径、厚度分别为(4.12±2.36)cm、(1.02±0.61)cm,均大于IH(t=-5.794、P<0.001,t=-2.113、P=0.036),超声下以低回声和数个无回声管腔的混合回声为主,可见钙化,边界清;IH病灶最大径、厚度分别为(2.54±1.21)cm、(0.85±0.47)cm,超声显示IH高低混合回声和低回声为主,边界清。彩色多普勒显示CH和IH血管密度分别为(6.01±1.10)/cm^2和(5.32±1.40)/cm^2(t=-3.794,P<0.001);频谱多普勒显示CH和IH为低速、低阻;三维彩色多普勒显示树枝状血流,IH多数有1条较粗供血动脉,CH有2条(χ^2=3.948,P=0.047)。比较3种CH,NICH多为低回声和数个无回声管腔的混合回声,RICH多为低回声,RICH、PICH病灶最大径和厚度大于NICH(t=3.411、P=0.002,t=4.200、P<0.001,t=2.552、P=0.015,t=3.016、P=0.015),NICH血管密度高于RICH和PICH(t=-3.209、P=0.002,t=2.485、P=0.016),PICH病灶无回声管腔较宽,管径大于RICH和NICH(t=2.911、P=0.005,t=2.717、P<0.001)。结论CH较IH病灶更大,内见无回声管腔及钙化,血管密度更高,两者三维彩色多普勒均呈树枝状,可见IH有1条、CH有2条较粗供血动脉。RICH、PICH病灶最大径和厚度大于NICH,NICH血管密度高于RICH和PICH。超声检查能有效辅助临床诊断CH。
Objective This study evaluated two-dimensional and three-dimensional ultrasound(US)features of congenital Hemangioma(CH),and to compare it with infantile hemangioma(IH).Methods Between December 2015 and January 2019,ultrasound examination of IH and CH cases were carried out in the Ninth People’s Hospital Affiliated to Medical School of Shanghai Jiao Tong University.US findings were retrospectively evaluated.On US images,the size,depth,echotexture,echogenicity,margin,vessel density,blood flow velocity and 3-dimension ultrasound pattern were recorded.Students’t,variance analysis,K-W test and χ^2 test were used for comparison.Results A total of 93 CH cases and 94 IH ones were included in the study.There were 59 males and 34 females aged from 5 days to 3 years.Among 93 CH cases,30 cases were rapid involuting congenital hemangioma(RICH),42 cases were non involuting congenital hemangioma(NICH),and 21 cases were partial involuting congenital hemangioma(PICH).There were 98 lesions in 94 patients with IH,including 22 males and 72 females,aged from 1 month to 1 year.The maximum diameter and depth of CH was(4.12±2.36)cm and(1.02±0.61)cm respectively,the lesions were mixed echoic with hypo-echo and many visible vessels mainly with well-defined,sometimes calcification.The maximum diameter and depth of IH was(2.54±1.21)cm and(0.85±0.47)cm respectively,the lesions were mixed echoic with hyper-and hypo-echo,and hypoechoic mainly with well-defined.The vascular density of IH and CH was(5.32±1.40)/cm^2 and(6.01±1.10)/cm^2(t=-3.794,P<0.001)respectively with low arterial peak systolic velocity and low resistance index.The 3-dimension color Doppler revealed branch-shape blood flow for IH and CH.IH showed one supply artery and CH showed two(χ2=3.948,P=0.047).Compared with the three kinds of CH,NICH is mostly mixed echo,RICH is mostly hypoechoic,the maximum diameter and thickness of RICH and PICH lesions are larger than NICH(t=3.411,P=0.002;t=4.200,P<0.001;t=2.552,P=0.015;t=3.016,P=0.015).The vascular density of NICH is higher than RICH and PICH(t=-3.209,P=0.002;t=2.485,P=0.016).And the anechoic lumen of PICH lesions is wider than RICH and NICH(t=2.911,P=0.005;t=2.717,P<0.001).Conclusions CH lesion was larger than IH one,with visible vessels and calcification on ultrasound,and higher vascular density.The three-dimension color Doppler revealed that IH had one supply artery and CH had two.The maximum diameter and thickness of RICH and PICH lesions are larger than NICH,the vascular density of NICH is higher than RICH and PICH.
作者
龚霞
李佳
熊屏
华晨
丁昂昂
周璐
李东源
吕欢
Gong Xia;Li Jia;Xiong Ping;Hua Chen;Ding Ang’ang;Zhou Lu;Li Dongyuan;Lyu Huan(Department of Ultrasound,the Ninth People’s Hospital of Shanghai,School of Medicine,Shanghai Jiao Tong University,Shanghai 200011,China;Department of Plastic and Reconstruction Surgery,Shanghai Ninth People’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200011,China)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2020年第9期1011-1017,共7页
Chinese Journal of Plastic Surgery
关键词
超声检查
二维
超声检查
三维
先天性血管瘤
婴幼儿血管瘤
Ultrasonography,two-dimensional
Ultrasonography,three-dimensional
Congenital Hemangioma
Infantile hemangioma
