【摘要】 目的 分析多发血管球瘤患者的临床资料，探讨其临床及影像学特征。方法 2018年1月—2023年6月河南省人民医院诊治多发血管球瘤患者9例，均行手术切除治疗，术前均行超声及X线、MRI检查，记录患者发病年龄、确诊时年龄、确诊前诊疗时间、症状、体征及瘤体部位、数量等临床资料，分析其临床及影像学特征。结果 9例患者发病年龄7～48岁，确诊时年龄13～54岁，确诊前诊疗时间1～38年，误诊为生长痛、肌肉劳损、肌筋膜炎、腱鞘炎、脉管炎、静脉畸形等；血管球瘤位于手部1例，大腿后部1例，小腿和/或足部7例；临床表现为间歇发作性剧烈疼痛、压痛、冷敏感、活动受限9例，局部软组织肿胀8例，患肢变细7例；9例患者血管球瘤数量共118个，其中位于皮下35个，肌肉15个，肌间隙68个；长径2.4～45.0 mm;超声表现为皮下、肌肉、肌间隙多发低回声团块，边界清、形态规则、内可见丰富血流信号，周围软组织水肿；X线检查显示病变区域骨骼均未见异常；MRI检查显示T₁WI多发低信号，T₂WI压脂像多发不均匀中等高信号团块影，周围软组织水肿高信号影。结论 多发血管球瘤临床主要表现为间歇发作性剧烈疼痛、压痛、冷敏感及局部软组织肿胀，可作为其诊断的四联征；超声声像特征主要表现为多发低回声、边界清、形态规则、内有丰富血流信号团块影及周围软组织水肿；MRI影像特征为T₁低信号、T₂高信号多发团块影及周围软组织水肿。更多还原

【Abstract】 Objective To analyze the clinical data of the patients with multiple glomus tumors,and to discuss their clinical and imaging features.Methods Nine patients with multiple glomus tumors received resection after ultrasound,X-ray and MRI scan examination in Henan Provincial People’s Hospital from January 2018to June 2023.The clinical data were collected as the age of onset,age of diagnosis,previous diagnosis and treatment duration,symptoms and signs as well as the tumor location and number.The clinical and imaging features were analyzed.Results The onset age ranged from 7to 48years old,and the age of diagnosis ranged from 13to 54years old.Their misdiagnosis and mistreatment lasted for 1to 38years.The patients were misdiagnosed with growing pains,muscle strain,myofasciitis,tenosynovitis,vasculitis,or venous malformation.The glomus tumors were located in hand in 1case,thigh in 1case,and calf and/or foot in 7cases.The clinical manifestations included intermittent episodes of severe pain,pressure pain and cold sensitivity in 9cases,local soft tissue swelling in 8,and thinning of the affected limb in 7.There were totally 118glomus tumors in9patients,including 35of subcutaneous,15of muscular,and 68of interosseous.The long diameter was 2.4to 45.0mm.The ultrasound features presented as hypoechoic masses with clear boundaries,regular morphology,and abundant blood flow signals and local edema in surrounding tissues,scattering in subcutaneous,muscular,and interosseous tissues.X-ray showed no abnormal skeletal changes in lesion area.The MRI appearance showed multiple low signal areas on T₁ weighted images,multiple uneven moderate-high signal mass shadows on T₂ weighted images,and significant high signal liquid shadows around.Conclusions Multiple glomus tumors clinically present as intermittent episodes of severe pain,pressure pain,cold sensitivity and local soft tissue swelling,which can be considered as the clinical tetralogy of multiple glomus tumors.The ultrasound features include multiple hypoechoic mass with clear boundary,regular morphology,abundant blood flow signal mass inside,and local surrounding tissue edema.MRI images are featured by multiple masses with low T₁signals and high T₂signals,as well as local edema imaging in surrounding tissues.更多还原