Dubois J, Patriquin H B, Garel L, Powell J, Filiatrault D, David M, Grignon A
Department of Medical Imaging, Hôpital Sainte-Justine, Montréal, Québec, Canada.
AJR Am J Roentgenol. 1998 Jul;171(1):247-52. doi: 10.2214/ajr.171.1.9648798.
We describe the sonographic appearance and vascularization of hemangiomas and determine if vessel density and peak systolic Doppler shifts distinguish hemangiomas from other superficial soft-tissue masses.
Our pilot study included 20 infants and children with hemangiomas who were to undergo biopsy before treatment with interferon alpha-2b. We used Doppler sonography to determine the number of vessels per square centimeter, peak arterial Doppler shift, resistive index, and signs of arteriovenous shunting. All hemangiomas showed high vessel density (more than five per square centimeter) and high Doppler shifts (more than 2 kHz), and these two factors became our diagnostic criteria. A prospective study of 116 patients was then carried out. One hundred sixteen consecutive pediatric patients with superficial soft-tissue masses were examined using Doppler sonography; sonographic findings were compared with the final diagnoses that were established by biopsy, CT, or clinical follow-up.
The final diagnoses included 70 hemangiomas, 20 venous malformations, three arteriovenous malformations, three arteriolocapillary malformations, and 20 other masses. Fifty-nine lesions showing high vessel density (more than five per square centimeter) and a peak arterial Doppler shift exceeding 2 kHz were correctly diagnosed as hemangiomas (sensitivity, 84%; specificity, 98%). One arteriovenous malformation showed high vessel density and high Doppler shifts, but none of the other masses that were not hemangiomas did. Eleven patients with hemangiomas who were being treated with interferon at the time of the study fulfilled only one of the two diagnostic criteria.
High vessel density and high peak arterial Doppler shift can be used to distinguish hemangiomas from other soft-tissue masses.
我们描述血管瘤的超声表现及血管形成情况，并确定血管密度和收缩期峰值多普勒频移是否能将血管瘤与其他浅表软组织肿块区分开来。
我们的初步研究纳入了20例拟在接受α-2b干扰素治疗前行活检的婴幼儿血管瘤患者。我们使用多普勒超声来确定每平方厘米的血管数量、动脉峰值多普勒频移、阻力指数以及动静脉分流的征象。所有血管瘤均显示出高血管密度（每平方厘米超过5个）和高频移（超过2kHz），这两个因素成为我们的诊断标准。随后对116例患者进行了前瞻性研究。连续116例患有浅表软组织肿块的儿科患者接受了多普勒超声检查；超声检查结果与通过活检、CT或临床随访确定的最终诊断结果进行了比较。
最终诊断包括70例血管瘤、20例静脉畸形、3例动静脉畸形、3例小动脉毛细血管畸形以及20例其他肿块。59个显示高血管密度（每平方厘米超过5个）且动脉峰值多普勒频移超过2kHz的病变被正确诊断为血管瘤（敏感性为84%；特异性为98%）。1例动静脉畸形显示高血管密度和高频移，但其他非血管瘤性肿块均未出现这种情况。在研究期间接受干扰素治疗的11例血管瘤患者仅符合两项诊断标准中的一项。
高血管密度和高动脉峰值多普勒频移可用于将血管瘤与其他软组织肿块区分开来。
