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目的:探讨二维及彩色多普勒超声对平滑肌肉瘤(LMS)的诊断价值。方法:收集我院2005~2014年间经手术病理证实为LMS的患者58例,回顾性分析患者的临床及超声图像资料。结果:共收集患者58例(共分析61个病灶),男性21例,女性37例,平均年龄(51.7±13.3)岁,61个病灶中分布于腹腔及腹膜后的有45个,躯干及四肢13个,下腔及股总静脉3个;所有病人超声均发现病灶,发现率为100%,超声定位准确率95%;肿瘤平均大小(8.6±5.8)cm,低弱回声52个(85.2%),边界较清楚45个(73.8%),形态不规则36个(59.0%),内部回声不均匀31个(50.8%),伴液化13个(21.3%),钙化4个(6.6%)。血流分级:0级15个(24.6%),1~2级38个(62.3%),3级8个(13.1%);超声提示肿瘤包绕或压迫邻近器官20例;提示对周围组织侵犯13例,超声与CT/MRI相比,两组病变发现率、定位准确率、提示包绕压迫征象及浸润征象率的差异无统计学意义(P>0.05)。结论:LMS好发于中老年,腹膜后多见,超声多表现为较大体积的低弱回声团块,边界较清,内部可见点线状血流信号,超声对LMS的发现率、定位准确率高,并能提示肿瘤对周围组织的压迫或浸润。
Objective: To investigate the value of two-dimensional and color Doppler ultrasound in the diagnosis of leiomyosarcoma (LMS). Methods: Fifty-eight patients with LMS confirmed by surgery and pathology in our hospital from 2005 to 2014 were retrospectively analyzed. The clinical and ultrasonographic data were retrospectively analyzed. Results: A total of 58 patients were collected (61 lesions were analyzed), 21 males and 37 females, with an average age of (51.7 ± 13.3) years. There were 45 lesions distributed in the abdominal cavity and retroperitoneum in 61 lesions, 13 cases, 3 cases of inferior vena cava and common femoral vein. All cases were found by ultrasonography, the detection rate was 100%, and the accuracy of ultrasound localization was 95%. The mean tumor size was 8.6 ± 5.8 cm, ), 45 (73.8%) with clear boundaries, 36 (59.0%) with irregular shape, 31 (50.8%) with internal echo unevenness, 13 (21.3%) with liquefaction and 4 (6.6%) with calcification. Blood grade was 15 (24.6%) in grade 0, 38 (62.3%) in grade 1 ~ 2 and 8 (13.1%) in grade 3; ultrasound showed that the tumor surrounded or oppressed the adjacent organs in 20 cases; In 13 cases, there was no significant difference between the two groups in the detection rate of lesions and the accuracy of location in ultrasound and CT / MRI (P> 0.05). Conclusion: LMS occurs mainly in the middle-aged and elderly patients. The retroperitoneum is more common. The ultrasound manifests itself in a larger volume of low-intensity echogenic mass with clearer boundaries and linear blood flow signals inside. The detection rate and location of LMS by ultrasound are accurate High rate, and can prompt tumor compression or infiltration of the surrounding tissue.