Department of Orthopaedic Surgery, Nippon Medical School.
Department of Orthopaedic Surgery, Nippon Medical School Tama Nagayama Hospital.
J Nippon Med Sch. 2021 Jan 8;87(6):318-324. doi: 10.1272/jnms.JNMS.2020_87-602. Epub 2020 Mar 31.
Angioleiomyomas typically present as small, painful, soft-tissue tumors less than 2 cm in diameter. The features of angioleiomyomas on magnetic resonance (MR) imaging are not well understood, and the association of MR findings with histologic subtype is unclear. In the present study, the MR features of angioleiomyomas of average size were compared in relation to histologic subtype.
This retrospective review of medical records analyzed MR imaging data and histologic specimens from 18 consecutive patients with angioleiomyomas that were resected at our hospital during the period from January 2006 through December 2013.
On T1-weighted images, lesions exhibited homogeneous areas that were isointense with skeletal muscle. However, T2-weighted images of solid and venous angioleiomyomas showed heterogeneous areas that were isointense or slightly hyperintense, while cavernous angioleiomyomas exhibited hyperintensity. Most lesions had a hypointense rim, and two thirds had adjacent vessels.
Our results suggest that MR findings for angioleiomyoma vary in relation to histologic subtype. T2-weighted images of solid and venous angioleiomyomas yielded specific MR findings that allowed for differentiation from other soft-tissue tumors, such as soft-tissue sarcomas. Most of these tumors exhibited isointense to slightly hyperintense regions, as compared with skeletal muscle, while findings for cavernous angioleiomyomas were nonspecific. Thus, clinical findings and MR imaging were almost sufficient for preoperative diagnosis of solid and venous angioleiomyomas.
血管平滑肌瘤通常表现为直径小于 2cm 的小而疼痛的软组织肿瘤。磁共振成像(MR)上的血管平滑肌瘤特征尚未得到很好的理解,并且 MR 发现与组织学亚型的关联也不清楚。在本研究中,比较了平均大小的血管平滑肌瘤的 MR 特征与组织学亚型的关系。
这是一项回顾性病历分析研究,分析了 2006 年 1 月至 2013 年 12 月期间在我院切除的 18 例血管平滑肌瘤患者的 MR 成像数据和组织学标本。
在 T1 加权图像上,病变表现为与骨骼肌等信号的均匀区域。然而,实性和静脉型血管平滑肌瘤的 T2 加权图像显示出等信号或稍高信号的异质区域,而海绵状血管平滑肌瘤则显示高信号。大多数病变有低信号环,三分之二有相邻血管。
我们的结果表明,血管平滑肌瘤的 MR 表现与组织学亚型有关。实性和静脉型血管平滑肌瘤的 T2 加权图像产生了特定的 MR 发现,可与其他软组织肿瘤(如软组织肉瘤)相鉴别。与骨骼肌相比,这些肿瘤的大多数表现为等信号或稍高信号区域,而海绵状血管平滑肌瘤的表现则是非特异性的。因此,临床发现和 MR 成像几乎足以对实性和静脉型血管平滑肌瘤进行术前诊断。