Paltiel H J, Burrows P E, Kozakewich H P, Zurakowski D, Mulliken J B
Department of Radiology, Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Radiology. 2000 Mar;214(3):747-54. doi: 10.1148/radiology.214.3.r00mr21747.
To determine the ultrasonographic (US) features that distinguish soft-tissue hemangioma from vascular malformation and one type of malformation from another.
Eighty-seven vascular anomalies were evaluated by means of US. Lesions were assessed for the presence of solid tissue and abnormal arteries, veins, or cysts. Vessel density, peak flow velocities, and resistive indexes were compared.
There were 49 hemangiomas and 38 vascular malformations. A significantly greater proportion of hemangiomas (48 of 49) compared with vascular malformations (zero of 38) consisted of a solid-tissue mass (P < .001). Vessel density was comparable for hemangioma and arteriovenous malformation (AVM) but significantly greater compared with the other vascular malformations (P < .001 in each case). No differences in mean arterial peak velocity were detected between hemangiomas and malformations. Mean venous peak velocity was significantly higher for AVM than for other vascular malformations and hemangioma. Mean resistive index was greater for lymphatic malformation than for hemangioma or AVM. Abnormal veins, arteries and veins, or cysts were univariate predictors for distinguishing between venous, arteriovenous, and lymphatic malformations (P < .001 in all cases). Solid-tissue mass was the only multivariate predictor for differentiating hemangioma from vascular malformation (likelihood ratio test = 109.8, P < .001).
US can be used to distinguish hemangioma from vascular malformation and detect arterial flow. These distinctions are critical for subsequent management and assessing prognosis.
确定能区分软组织血管瘤与血管畸形以及一种血管畸形与另一种血管畸形的超声（US）特征。
采用超声对87例血管异常进行评估。评估病变中实性组织、异常动脉、静脉或囊肿的存在情况。比较血管密度、峰值流速和阻力指数。
有49例血管瘤和38例血管畸形。与血管畸形（38例中0例）相比，血管瘤（49例中有48例）中实性组织肿块的比例显著更高（P <.001）。血管瘤和动静脉畸形（AVM）的血管密度相当，但与其他血管畸形相比显著更高（每种情况P <.001）。血管瘤与畸形之间未检测到平均动脉峰值流速的差异。AVM的平均静脉峰值流速显著高于其他血管畸形和血管瘤。淋巴管畸形的平均阻力指数高于血管瘤或AVM。异常静脉、动脉和静脉或囊肿是区分静脉、动静脉和淋巴管畸形的单变量预测因素（所有情况P <.001）。实性组织肿块是区分血管瘤与血管畸形的唯一多变量预测因素（似然比检验 = 109.8，P <.001）。
超声可用于区分血管瘤与血管畸形并检测动脉血流。这些区分对于后续治疗和评估预后至关重要。
