Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
J Vasc Surg Venous Lymphat Disord. 2019 Sep;7(5):715-723. doi: 10.1016/j.jvsv.2019.01.065.
For vascular anomalies, when clinical findings are not sufficient, auxiliary examination is essential. In this study, we characterize and differentiate the ultrasound (US) findings of deep infantile hemangioma (DIH) and venous malformation (VM).
A total of 135 patients (140 lesions) with clinically proven DIH and VM were analyzed. The following US characteristics were assessed: size, shape, border, echogenicity, echotexture, vascularity, and lesion softness. One-way analysis of variance, nonparametric test, χ test, Fisher exact test, and paired sample t-test were used to analyze the US results.
On gray-scale US images, DIH and VM were more common in subcutaneous soft tissue, but VM could invade the muscle. Most DIHs were expressed as hyperechoic structures (47.0%), had a well-defined border (74.2%), and were homogeneous (53%), whereas the majority of VMs showed mixed echoic with anechoic structures (87.8%), had an ill-defined border (58.1%), and were heterogeneous (100%). On color Doppler US, most DIHs (90.9%) showed high vascular density, whereas only a few blood flow signals were found in most VMs (98.6%). On elastic US, VM was softer than DIH (2.9 ± 0.8 vs 2.6 ± 0.5; P = .048). After DIH involution, the distance from the body surface increased (P = .015); the lesion's vertical diameter, peak arterial systolic velocity, and Vmax were significantly decreased (P = .006, P = .047, and P = .026, respectively). Also, early VM (<18 months) has the typical US performance of VM. Compared with elastic US, gray-scale and Doppler US provided stronger evidence for differential diagnosis.
DIH and VM have different US manifestations that can provide evidence for diagnosis and differential diagnosis of DIH and early VM.
对于血管畸形，如果临床表现不充分，辅助检查是必不可少的。本研究旨在描述和区分深部婴儿血管瘤（DIH）和静脉畸形（VM）的超声（US）表现。
分析了 135 例（140 个病灶）经临床证实的 DIH 和 VM 患者的 US 特征，评估了以下指标：大小、形状、边界、回声、回声质地、血流和病灶柔软度。采用单因素方差分析、非参数检验、卡方检验、Fisher 确切概率法和配对样本 t 检验分析 US 结果。
在灰阶 US 图像上，DIH 和 VM 更常见于皮下软组织，但 VM 可侵犯肌肉。大多数 DIH 表现为高回声结构（47.0%），边界清晰（74.2%），回声均匀（53%），而大多数 VM 表现为混合回声伴无回声结构（87.8%），边界不清（58.1%），回声不均匀（100%）。彩色多普勒 US 显示，大多数 DIH（90.9%）显示高血管密度，而大多数 VM 仅显示少量血流信号（98.6%）。在弹性 US 上，VM 比 DIH 更软（2.9±0.8 比 2.6±0.5；P=0.048）。DIH 消退后，距体表距离增加（P=0.015）；病灶垂直直径、峰值动脉收缩速度和 Vmax 明显降低（P=0.006、P=0.047 和 P=0.026）。此外，早期 VM（<18 个月）具有典型的 VM US 表现。与弹性 US 相比，灰阶和多普勒 US 为 DIH 和早期 VM 的鉴别诊断提供了更强的证据。
DIH 和 VM 的 US 表现不同，可为 DIH 和早期 VM 的诊断和鉴别诊断提供依据。
