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目的通过总结韧带样型纤维瘤病(DF)的超声图像表现和病理学结构,以提高对DF的认识和诊断水平。方法回顾性分析2005年1月-2011年12月70例经手术和病理组织学证实为DF患者的超声图像和病理组织学结果。结果 DF肿块的超声表现与病理结构密切相关。70例DF中腹部外型41例(58.6%)、腹壁型18例(25.7%)、腹内型11例(15.7%)。DF的典型超声图像表现为沿肌纤维浸润性生长的低回声肿块,累及多块肌肉;肿块无包膜,多数形态不规则、边界不清;其中8例包绕和侵犯相邻骨质,12例肿瘤压迫或侵犯邻近血管、神经、肠管等组织;40例瘤体内探及Ⅰ级血流信号,4例探及Ⅲ级血流信号;所有病变均未见坏死出血和囊变,病变周围无淋巴结肿大。结论 DF的声像图表现有较强的特征性,超声能较为准确判断肿块累及范围、是否侵犯相邻骨质、与毗邻血管、神经的关系,有助于制定手术计划。
OBJECTIVE To improve the understanding and diagnosis of DF by summarizing the ultrasound image and pathology of ligament-like fibromatosis (DF). Methods From January 2005 to December 2011, 70 patients with DF confirmed by surgery and histopathology were retrospectively analyzed by ultrasound and histopathology. Results The ultrasound manifestations of DF mass were closely related to the pathological structure. There were 41 cases (58.6%) of middle abdomen in 70 cases, 18 cases (25.7%) in abdominal wall and 11 cases (15.7%) in intra-abdominal type. The typical ultrasonography of DF showed hypoechoic mass with infiltrative growth along the muscle fiber, which involved multiple muscles. The masses of the mass showed no capsule, most of the masses were irregular and the border was unclear. Among them, 8 cases encircled and infiltrated adjacent bone and 12 Tumor compression or invasion of adjacent blood vessels, nerves, intestine and other tissues; 40 cases of exploration of the tumor and grade Ⅰ blood flow signals, 4 cases of exploration and grade Ⅲ blood flow signals; no necrosis of all lesions were hemorrhagic and cystic lesions without lymph node Swollen Conclusion The sonographic features of DF have strong characteristic features. Ultrasound can determine the extent of tumor involvement more accurately, and infiltrate the adjacent bone and the relationship with adjacent blood vessels and nerves, which is helpful to make the surgical plan.