CAJ | 학술논문

目的分析软组织血管瘤的影像诊断和鉴别诊断,以及介入治疗经验.方法 29例患者,1例婴儿左侧面部巨大毛细血管瘤行左侧颈外动脉造影,未行栓塞治疗;26例静脉畸形中,13例行穿刺造影和无水乙醇加平阳霉素和碘油乳剂硬化治疗;1例左肘和1例右小腿肌肉蔓状血管瘤(AVF和AVM)使用真丝线段或PVA颗粒行末梢动脉栓塞,使用钢圈行主干栓塞.结果 1例要儿面部巨大毛细血管瘤供血动脉增粗,染色明显,引流静脉增粗.10例静脉畸形的X线平片显示静脉石;13例MRI显示T_1等信号,T_2高信号,增强有强化;3例CT示血管瘤软组织肿块;9例初诊彩超显示血管瘤内异常血流.行血管瘤造影18例,成功16例,其中行血管瘤硬化治疗13例,注射1～5次,无水乙醇碘油乳剂硬化治疗5例,痊愈1例,好转4例; 无水乙醇加平阳霉素和碘油乳剂治疗8例,其中6例痊愈,2例好转.结论软组织血管瘤正确的影像诊断可协助治疗方案的制订.根据血管畸形的血流情况可采用不同的介入方法.
목적 분석연조직혈관류적영상진단화감별진단,이급개입치료경험.방법 29례환자,1례영인좌측면부거대모세혈관류행좌측경외동맥조영,미행전새치료;26례정맥기형중,13례행천자조영화무수을순가평양매소화전유유제경화치료;1례좌주화1례우소퇴기육만상혈관류(AVF화AVM)사용진사선단혹PVA과립행말소동맥전새,사용강권행주간전새.결과 1례요인면부거대모세혈관류공혈동맥증조,염색명현,인류정맥증조.10례정맥기형적X선평편현시정맥석;13례MRI현시T_1등신호,T_2고신호,증강유강화;3례CT시혈관류연조직종괴;9례초진채초현시혈관류내이상혈류.행혈관류조영18례,성공16례,기중행혈관류경화치료13례,주사1～5차,무수을순전유유제경화치료5례,전유1례,호전4례; 무수을순가평양매소화전유유제치료8례,기중6례전유,2례호전.결론 연조직혈관류정학적영상진단가협조치료방안적제정.근거혈관기형적혈류정황가채용불동적개입방법.
Objective To analyse the imaging diagnosis and differential diagnosis,as well as the experience of interventional therapy of soft tissue hemangioma. Methods There were 29 patients with soft tissue hemangiomas in this study,including 1 bady with left facial huge capillary hemangioma received left external carotid artery angiography and no embolization,26 cases of venous malformation,among them 13 underwent puncture angiography and ethanol + pingyangmycin+lipiodol emulsion sclerotherapy and 2 patients with cirsoid hemangioma(AVF and AVM) ,of them one case in left elbow and another case in right lower leg muscle,the silk line segments or PVA particles were used to perform peripheral arterial embolization, the arterial trunk was embolized with steel coils. Results The great facial capillary hemangioma in one infant had thicken feeding artery and enlarged draining vein, the tumor stained obviously. The phlebolithes were showed by radiography in 10 cases with venous malformation on MRI, the lesions showed isointensity on T_1 WI, hyperintensity on T_2WI in 13 cases and enhancement on contrast-enhanced MRI. CT showed soft tissue mass in 3 cases ; ultrasonography showed abnormal blood flow in 9 cases. Angiography was done in 18 cases, of which 16 cases were successful. In these 16 cases,the sclerosing treatment for hemangiomas was 1～5 times,of them,5 cases treated with ethanol lipiodol e-mulsion sclerotherapy (one case cured and 4 cases improved) and 8 cases treated with pingyangmycin plus ethanol and lipiodol, of which 6 cured and 2 cases improved. Conclusion Correct diagnosis of the soft tissue hemangiomas by imaging can help to design the different treatment programs,and the programs designed for treating hemangiomas are need in consideration of the blood flow of the tumors.