·论著·彩色多普勒超声在头面部血管瘤和血管畸形诊断分类与疗效评价中的应用李虹,秦中平△,何兴振,李爱萍[摘要]目的探讨彩色多普勒超声对血管瘤和血管畸形病变的诊断分类及疗效评价的价值。方法对168例头面部血管瘤和血管畸形进行彩超检查,根据声像图特征和血流动力学特点进行分类,对DSA检查证实为高流速血管畸形常规行供血动脉栓塞治疗。结果分为四种类型,即单纯血管瘤49例,血管瘤合并血管畸形21例,经随访观察或手术后病理证实两类病变的超声诊断正确率分别为95191%和9015%。高流速血管畸形38例,低流速血管畸形60例,经DSA检查和术后病理证实两类病变的超声诊断正确率分别为100%和96167%。38例高流速血管畸形中72条供血动脉全部行栓塞治疗,栓塞前后的动脉平均收缩峰血流速度分别为(144153±3819)cm/s和(8612±3613)cm/s,阻力指数分别为0165±0104和0180±0105(均P<0101)。结论彩超检查对血管瘤和血管畸形病变能做出正确的诊断分类,对临床选择合理的治疗方案具有重要的指导意义,对动脉栓塞疗效评价提出了理论数据。[关键词]彩色多普勒超声;血管瘤;血管畸形;分类;疗效[中图分类号]R44511[文献标识码]A[文章编号]1681-2824(2009)01-0027-03Applicationofcolorultrasonicindiagnosticclassificationandtherapyofmaxillo2facialhemangiomaandvascularmalformationLIHong,QINZhong2ping,HEXing2zhen,etal.UltrasonicDepartment,LinyiTumorHospitalofShandong,Linyi276001,China[Abstract]ObjectiveToexplorethediagnosticclassification,differentialdiagnosticvalueandcurativeeffecte2valuationbeforeandaftertreatmentofcolorDopplerultrasonographyinmaxillofacialhemangiomaandvascularmal2formationlesion.MethodsPerformedcolorDopplerultrasonographyto168casesofmaxillofacialhemangiomaandvascularmalformation.Accordingtoultrasonicfeatures,classifytotheformergroup,gaveoralprednisonetherapyandtheothergroup,gavehigh2flowlesionandlow2flowlesion.Tothehigh2flowvascularmalformationwhichweretestifiedbyDSAexamination,regularlygaveembolizationoftumorsupplyingartery.Results49casesshowedhighorlowechomassandrarebloodsignalandwerediagnosedashemangiomasimplex;21casesshowedlowechomassbutseveraltubularbloodsignal,abundantbloodcirculationandwerediagnosedashemangiomaassociatedwithvas2cularmalformation.38casesweredetectedoneormoresupplyingarteriesandultrasonicdiagnosiswerehigh2flowvascularmalformation;60casesshowedlessbloodstreamandmostwerevenousbloodstreamandultrasonicdiag2nosiswerelow2flowvascularmalformation.ThroughtheDSAexaminationandafteroperationpathology,itwastesti2fiedthattheultrasonicdiagnosticaccuracyof2typelesionwere100%and96.67%respectively.Amongthe38ca2sesofhighflowvascularmalformation,doembolizationtoallthe72supplyingarteries.Beforeandafteremboliza2tion,theaveragevelocitypeakofvesselwere(144153±3819)cm/sand(8612±3613)cm/srespectively,andre2sistanceindexeswere0165±0104and0180±0105(P<0101)respectively.ConclusionColorultrasoniccanmakecorrectdiagnosticclassificationanddifferentialdiagnosisandhasguidingsignificanceinselectingappropriateclinicaltreatmentoptionsandevaluatingcurativeeffectsbeforeandafterarteryembolization.[Keywords]colorDopplerultrasonography;hemangioma;vascularmalformation;classify;therapyeffect作者单位:276001山东临沂,临沂市肿瘤医院超声科(△血管瘤特色专科)·72·中华现代影像学杂志JournalofChineseModernImaging2009年第6卷第1期头面部血管瘤和血管畸形是一种常见的良性肿瘤,由于其病程演变、治疗方法及预后等都不相同,因而对其做出正确诊断及分类非常重要。笔者分析168例头面部血管瘤和血管畸形的声像学特征进行诊断及分类,并对38例瘤体供血动脉栓塞治疗后再检查,以评价疗效,现报告如下。1资料与方法111一般资料本组系2004...
