Griffin N, Khan N, Thomas J Meirion, Fisher C, Moskovic E C
Department of Diagnostic Imaging, Royal Marsden Hospital, 203 Fulham Road, London SW3 6JJ, UK.
Skeletal Radiol. 2007 Nov;36(11):1051-9. doi: 10.1007/s00256-007-0375-6. Epub 2007 Sep 12.
Intramuscular haemangiomas in adults may appear similar to soft tissue sarcomas on imaging. This study evaluates the imaging characteristics of intramuscular haemangiomas on magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound.
Retrospective review of medical records, imaging and pathology details of 34 patients presenting with intramuscular haemangiomas was performed. Age of patient, size, site of lesion and type of imaging was recorded. Lesions were evaluated for calcification, presence of fat, outline, texture, vascularity, enhancement and involvement of local structures.
There were 12 male and 22 female patients aged between 9 years and 90 years (mean 39 years). Twenty-two lesions involved muscles of the extremities and 12 involved muscles of the trunk. Mean duration of the lesions was long: 59.3 months (range 3-240 months), with an average size of 7.5 cm (1.5-15 cm). Imaging comprised 27 MR studies, seven CT scans, 19 ultrasounds, and eight plain films. All lesions were well defined, lobulated and heterogeneous. None showed local invasion. On MRI and CT, 93-100% showed the presence of fat and 100% showed vascular channels and enhancement on MRI, CT and ultrasound. Phleboliths were seen on four plain films (50%) and on the corresponding MR images. On MRI, 70% of lesions had mildly hyperintense signal on T1-weighted sequences and 96% had hyperintense signal on T2-weighted sequences (relative to skeletal muscle). Histopathology confirmed diagnosis in all cases, showing the presence of fat, medium/large vessels and skeletal muscle.
Intramuscular haemangiomas have characteristic appearances on MRI, CT and ultrasound. Long history, presence of fat, calcification and internal vessels should alert the radiologist to this diagnosis prior to biopsy.
成人肌内血管瘤在影像学上可能与软组织肉瘤相似。本研究评估肌内血管瘤在磁共振成像（MRI）、计算机断层扫描（CT）和超声检查中的影像学特征。
对34例肌内血管瘤患者的病历、影像学和病理学细节进行回顾性分析。记录患者年龄、病变大小、部位及影像学检查类型。对病变进行钙化、脂肪存在情况、轮廓、质地、血管分布、强化及局部结构受累情况的评估。
患者年龄9岁至90岁（平均39岁），男性12例，女性22例。22个病变累及四肢肌肉，12个累及躯干肌肉。病变平均病程较长：59.3个月（范围3 - 240个月），平均大小7.5 cm（1.5 - 15 cm）。影像学检查包括27例MRI、7例CT扫描、19例超声检查和8例平片。所有病变边界清晰、呈分叶状且不均匀。均未显示局部侵犯。在MRI和CT上，93% - 100%显示有脂肪存在，100%在MRI、CT和超声上显示有血管通道及强化。4例平片（50%）及相应的MR图像上可见静脉石。在MRI上，70%的病变在T1加权序列上呈轻度高信号，96%在T2加权序列上呈高信号（相对于骨骼肌）。所有病例经组织病理学确诊，显示有脂肪、中/大血管及骨骼肌。
肌内血管瘤在MRI、CT和超声上有特征性表现。病史较长、存在脂肪、钙化及内部血管应提示放射科医生在活检前考虑这一诊断。
