Department of Radiology, College of Medicine, Inje University, Busan Paik Hospital, Busanjin-ku, Busan, Korea.
Radiographics. 2010 Oct;30(6):1621-36. doi: 10.1148/rg.306105514.
Various types of tumors can affect the subungual space, including benign solid tumors (glomus tumor, subungual exostosis, soft-tissue chondroma, keratoacanthoma, hemangioma, lobular capillary hemangioma), benign cystic lesions (epidermal and mucoid cysts), and malignant tumors (squamous cell carcinoma, malignant melanoma). Imaging plays an important role in the detection and differentiation of subungual tumors because of their small size, nonspecific clinical manifestations, and functional significance. Ultrasonography (US)-in particular, high-resolution US with color Doppler studies-provides useful information regarding tumor size, location, shape, and internal characteristics (cystic, solid, or mixed), but it is limited in the further characterization of tissue. Magnetic resonance (MR) imaging has an important role in categorizing tumors according to their anatomic location, pathologic origin, and signal characteristics. There is some overlap between the US and MR imaging features of subungual tumors; however, certain features can allow accurate diagnosis and expedite management when correlated with clinical and pathologic findings.
各种类型的肿瘤都可能累及甲下空间,包括良性实体肿瘤(血管球瘤、甲下外生骨疣、软组织软骨瘤、角化棘皮瘤、血管瘤、小叶状毛细血管瘤)、良性囊性病变(表皮样囊肿和黏液囊肿)和恶性肿瘤(鳞状细胞癌、恶性黑色素瘤)。由于这些肿瘤体积小、临床表现不典型且具有重要的功能意义,影像学检查在检出和鉴别甲下肿瘤方面发挥着重要作用。超声检查(US),尤其是高分辨率 US 联合彩色多普勒检查,可为肿瘤的大小、位置、形态和内部特征(囊性、实性或混合性)提供有用信息,但对组织的进一步定性有限。磁共振成像(MR)在根据肿瘤的解剖位置、病理起源和信号特征进行分类方面具有重要作用。甲下肿瘤的 US 和 MR 成像特征有一定的重叠;然而,当与临床和病理发现相结合时,某些特征可实现准确诊断并加快治疗。