Schmitt R, Warmuth-Metz M, Lanz U, Lucas D, Feyerabend T, Schindler G
Abteilung für Röntgendiagnostik, Chirurgische Universitätsklinik, Würzburg.
Radiologe. 1990 Apr;30(4):185-92.
Computed tomography was carried out in 32 patients with clinically equivocal soft-tissue lesions of the hand (24 times) and forearm (8 times). The CT scans were performed with the patients in standard positions; thin slices and zoom technique were used. All soft-tissue tumors were correctly diagnosed with regard to localization, size and infiltration of the surrounding tissue. The histological diagnosis was correct in tendon-sheath proliferations, deposits caused by metabolic disorders, epithelial and ganglion cysts, hemangiomas, lipomas and in one schwannoma. A malignancy was suspected and was proven to be correct in two cases. False-positive diagnoses of a malignant soft-tissue tumor were made in one case of an aggressive fibromatosis, in a rapidly progressive, ossifying myositis, and three times in the presence of postoperative scar tissue following the resection of a sarcoma. Finally, a case of proliferative myositis regarded as semimalignant was underrated by CT. The hand surgeon considered CT diagnostics to be very helpful in planning operations in an anatomically complex organ such as the hand.
对32例手部(24例)和前臂(8例)临床诊断不明确的软组织病变患者进行了计算机断层扫描。CT扫描时患者处于标准体位;采用薄层扫描和放大技术。所有软组织肿瘤在定位、大小及周围组织浸润方面均得到正确诊断。腱鞘增生、代谢紊乱所致沉积物、上皮囊肿和腱鞘囊肿、血管瘤、脂肪瘤及1例神经鞘瘤的组织学诊断正确。怀疑有2例恶性肿瘤,结果证实正确。1例侵袭性纤维瘤病、1例快速进展性骨化性肌炎及1例肉瘤切除术后瘢痕组织存在时曾3次误诊为恶性软组织肿瘤。最后1例增生性肌炎被认为是半恶性的,但CT对其低估。手外科医生认为CT诊断对手部这样解剖结构复杂的器官手术规划非常有帮助。