Soft-tissue hemangiomas in infants and children: Diagnosis using Doppler sonography
Soft-tissue hemangiomas in infants and children: Diagnosis using Doppler sonography
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DOI：
10.2214/ajr.171.1.9648798
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发表时间：
1998-07-01
影响因子：
5
通讯作者：
Grignon, A
中科院分区：
文献类型：
--
作者：
Dubois, J;Patriquin, HB;Grignon, A
目的：描述血管瘤的声像图表现和血管化，并确定血管密度和峰值多普勒频移是否与其他浅表软组织肿块相鉴别。我们的初步研究包括20名患有血管瘤的婴儿和儿童，他们在接受干扰素α-2b治疗之前接受了活检。我们使用多普勒超声来确定每平方厘米的血管数目、最大动脉多普勒频移、阻力指数和动静脉分流的征象。所有的血管瘤都表现为高血管密度(每平方厘米大于5个)和高多普勒频移(大于2 kHz)，这两个因素成为我们的诊断标准。随后对116名患者进行了前瞻性研究。对116例儿童浅表软组织肿块进行了超声检查，并与经活检、CT或临床随访证实的结果进行对照。结果最终诊断为血管瘤70例，静脉畸形20例，动静脉畸形3例，动-毛细血管畸形3例，其他肿块20例。59个血管密度高(大于5个/平方厘米)且峰值动脉多普勒频移超过2 kHz的病变被正确诊断为血管瘤(敏感性84%，特异性98%)。1例动静脉畸形表现为高血管密度和高多普勒频移，而其他非血管瘤的肿块均无此表现。研究期间接受干扰素治疗的11名血管瘤患者仅符合两项诊断标准中的一项。结论：高血管密度和高峰值动脉多普勒频移可用于区分血管瘤和其他软组织肿块。
OBJECTIVE, 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.SUBJECTS AND METHODS. 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.RESULTS. 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.CONCLUSION. High vessel density and high peak arterial Doppler shift can be used to distinguish hemangiomas from other soft-tissue masses.