Furuta Taisuke, Shimose Shoji, Nakashima Yuko, Kubo Tadahiko, Ochi Mitsuo
1 Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Science, Hiroshima University, Hiroshima, Japan.
2 Department of Orthopaedic Surgery, National Hospital Organization Kure Medical Center, Japan.
Acta Radiol. 2017 Oct;58(10):1231-1237. doi: 10.1177/0284185116688379. Epub 2017 Jan 16.
Background Hemangiomas are sometimes difficult to diagnose with current techniques. Sluggish speed signs (SSS) are a phenomenon that: (i) cannot be depicted as Doppler flow on Doppler ultrasound; (ii) can be observed as fluid movements on Doppler ultrasound; and (iii) cannot be depicted as waveforms on pulse Doppler mode. We hypothesized that SSS could be diagnostic indicators for hemangiomas. Purpose To evaluate whether ultrasound findings, in particular those relating to SSS, are a reliable tool for detecting hemangiomas compared to magnetic resonance imaging (MRI) and the gold standard for hemangioma diagnosis: pathological examination by biopsy or after surgical resection. Material and Methods Totally, 105 patients (mean age, 44.9 years) with soft-tissue tumors underwent MRI and ultrasound examination before biopsy or tumor resection. Ultrasound findings were compared with MRI as well as pathological findings, which were used as reference. Results Hemangiomas were identified in 16 (6.25%) of the 105 patients. On MRI, flow voids showed sensitivity and specificity values of 81.3% and 96.6%, respectively. On ultrasound examination, SSS was the only finding to show equally high sensitivity (93.8%) and specificity (96.6%) for diagnosing hemangiomas. There was no significant difference in the diagnostic capabilities between these two parameters ( P = 0.479). Conclusion SSS showed a high sensitivity and specificity for diagnosing hemangiomas and therefore are useful diagnostic tools to supplement MRI.
背景 血管瘤有时难以用现有技术进行诊断。缓慢血流信号（SSS）是一种现象：（i）在多普勒超声上不能显示为多普勒血流；（ii）在多普勒超声上可观察为液体流动；（iii）在脉冲多普勒模式下不能显示为波形。我们推测SSS可能是血管瘤的诊断指标。目的 评估超声检查结果，尤其是与SSS相关的结果，与磁共振成像（MRI）以及血管瘤诊断的金标准：活检或手术切除后的病理检查相比，是否是检测血管瘤的可靠工具。材料与方法 共有105例软组织肿瘤患者（平均年龄44.9岁）在活检或肿瘤切除前接受了MRI和超声检查。将超声检查结果与MRI以及用作参考的病理结果进行比较。结果 105例患者中有16例（6.25%）被诊断为血管瘤。在MRI上，流空信号的敏感性和特异性分别为81.3%和96.6%。在超声检查中，SSS是唯一对血管瘤诊断显示出同样高敏感性（93.8%）和特异性（96.6%）的表现。这两个参数的诊断能力无显著差异（P = 0.479）。结论 SSS对血管瘤诊断显示出高敏感性和特异性，因此是补充MRI的有用诊断工具。
