Chen Samuel Huan-Tang, Chen Yao-Liang, Cheng Ming-Huei, Yeow Kee-Min, Chen Hung-Chi, Wei Fu-Chan
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Plast Reconstr Surg. 2003 Jul;112(1):115-9; discussion 120. doi: 10.1097/01.PRS.0000066163.81401.05.
Small glomus tumors of the digits of the hand are difficult to excise and may be associated with relatively high rates of recurrence. This study was designed to prospectively evaluate the utility of preoperative ultrasound localization of such tumors to facilitate removal and to reduce recurrence rates. During a 5-year period, 34 patients clinically diagnosed with glomus tumors involving their digits were examined with high-resolution ultrasonography (5 to 9 MHz). Color duplex sonography was further applied if flow characteristics were identified. The ultrasound-predicted and actual intraoperative sizes were correlated and analyzed using the paired t test. Patients were followed for 1 to 6 years, and results were documented. Sonography showed a hypoechoic nodule with prominent vascularity between the nail body and the dorsal cortex of the distal phalanx in all subungual tumors. Complete resection was possible in all 35 glomus tumors, with assistance by accurate preoperative ultrasound localization. There was no long-term recurrence among the 29 patients available for evaluation 1 to 6 years postoperatively. Ultrasonography has great advantages in defining the exact location and size of the glomus tumor preoperatively. Prior knowledge of the exact site and size of the glomus tumor facilitates excision and appears to reduce rates of recurrence. The collaboration between hand surgeons and radiologists is useful to successfully treat glomus tumors of the digit.
手部手指的小型血管球瘤难以切除，且可能具有相对较高的复发率。本研究旨在前瞻性评估此类肿瘤术前超声定位在促进切除及降低复发率方面的效用。在5年期间，对34例临床诊断为手指血管球瘤的患者进行了高分辨率超声检查（5至9兆赫）。若识别出血流特征，则进一步应用彩色双功超声检查。使用配对t检验对超声预测的和实际术中的大小进行相关性分析。对患者进行了1至6年的随访，并记录结果。超声检查显示，所有甲下肿瘤在指甲体与远节指骨背侧皮质之间均有一个低回声结节且血管丰富。在术前准确的超声定位辅助下，所有35个血管球瘤均得以完整切除。在术后1至6年可进行评估的29例患者中，无长期复发情况。超声检查在术前确定血管球瘤的确切位置和大小方面具有很大优势。了解血管球瘤的确切部位和大小有助于切除肿瘤，且似乎能降低复发率。手外科医生与放射科医生之间的合作对于成功治疗手指血管球瘤很有帮助。
