Nazarian L N, Alexander A A, Kurtz A B, Capuzzi D M, Rawool N M, Gilbert K R, Mastrangelo M J
Department of Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107-5244, USA.
AJR Am J Roentgenol. 1998 Feb;170(2):459-63. doi: 10.2214/ajr.170.2.9456964.
The purpose of this study was to describe the sonographic appearances of melanoma metastases of the skin, subcutaneous tissues, and superficial lymph nodes.
Gray-scale sonography was performed on 31 superficial melanoma metastases in 18 patients. Discreteness of borders, contours, echogenicity, echotexture, and degree of acoustic through-transmission were evaluated for each lesion. Color Doppler sonography was also performed on 25 of the 31 lesions, by which the amount of internal color flow was qualitatively assessed.
Twenty-eight (90%) of the 31 metastases had well-defined borders. Contours were smooth in 17 (55%), lobulated in 12 (39%), and spiculated in two (6%). Nineteen metastases (61%) were hypoechoic to muscle, 10 (32%) were isoechoic, and two (6%) were hyperechoic. Echotexture was homogeneous in six lesions (19%), mildly heterogeneous in 13 (42%), moderately heterogeneous in 11 (35%), and markedly heterogeneous in one (3%). Twenty-two lesions (71%) showed enhanced acoustic through-transmission. Of the 25 melanoma metastases for which we performed color Doppler sonography, 18 (72%) had internal arterial color flow and seven (28%) did not. The flow was characterized as mild in 13 (72%) of 18, moderate in four (22%), and marked in one (6%).
On sonography, superficial melanoma metastases typically are well-defined hypoechoic lesions with smooth or lobulated contours, mild to moderate heterogeneity, and enhanced acoustic through-transmission. Internal flow revealed by color Doppler sonography is present in many, but not all, superficial melanoma metastases.
本研究旨在描述皮肤、皮下组织及浅表淋巴结黑色素瘤转移灶的超声表现。
对18例患者的31个浅表黑色素瘤转移灶进行灰阶超声检查。评估每个病灶的边界清晰度、轮廓、回声性、回声纹理及后方回声增强程度。对31个病灶中的25个还进行了彩色多普勒超声检查，定性评估内部血流情况。
31个转移灶中28个（90%）边界清晰。轮廓光滑的有17个（55%），分叶状的有12个（39%），毛刺状的有2个（6%）。19个转移灶（61%）相对于肌肉呈低回声，10个（32%）呈等回声，2个（6%）呈高回声。6个病灶（19%）回声纹理均匀，13个（42%）轻度不均匀，11个（35%）中度不均匀，1个（3%）明显不均匀。22个病灶（71%）表现为后方回声增强。在进行彩色多普勒超声检查的25个黑色素瘤转移灶中，18个（72%）有内部动脉血流，7个（28%）没有。18个中有13个（72%）血流为轻度，4个（22%）为中度，1个（6%）为重度。
超声检查时，浅表黑色素瘤转移灶通常为边界清晰的低回声病灶，轮廓光滑或呈分叶状，轻度至中度不均匀，后方回声增强。彩色多普勒超声显示的内部血流在许多但并非所有浅表黑色素瘤转移灶中都存在。
