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The lipid-poor hemangioma: an investigation into the behavior of the "atypical" hemangioma.

低脂性血管瘤: 对 “非典型” 血管瘤行为的调查。

  • 影响因子:1.50
  • DOI:10.1007/s00256-019-03257-2
  • 作者列表:"Hoyle JM","Layfield LJ","Crim J
  • 发表时间:2020-01-01
Abstract

OBJECTIVE:Most vertebral hemangiomas contain high signal intensity on T1-weighted MRI images. Atypical vertebral hemangiomas, which are defined as showing low-signal intensity on T1-weighted images, have been described as lesions which are prone to aggressive behavior. This study was performed to assess behavior of atypical hemangiomas. MATERIALS AND METHODS:Thoracic and lumbar spine MRI reports for the year 2012 were reviewed for diagnosis of atypical hemangioma. Images were reviewed by two independent observers, and cases which showed atypical vertebral hemangioma, and had imaging or clinical follow-up, were included in our study. RESULTS:Thirty atypical hemangiomas which had follow-up data were identified out of 2784 thoracic and lumbar MR examinations performed during 2012 at a single institution. Imaging follow-up was available for 23 lesions (mean follow-up 32 months), while there was clinical follow-up for the remaining seven lesions (mean 43.6 months). Twenty-two lesions were stable on imaging, while one demonstrated significant growth over approximately 6 years, developing MRI signal characteristics of a typical hemangioma. Eleven lesions had CT scans showing typical features of hemangioma. Two of the index lesions could not be identified on follow-up CT examinations, which showed normal-appearing spines. The remaining seven lesions were followed clinically; none of the patients reported symptoms in the region of the index lesions. CONCLUSIONS:Atypical hemangiomas are uncommon lesions. The cases in our population did not show aggressive behavior. A more appropriate designation for these lesions may be lipid-poor hemangioma, to distinguish them from aggressive hemangiomas.

摘要

目的: 大多数椎体血管瘤在T1-weighted MRI图像上表现为高信号。非典型椎体血管瘤,定义为在T1-weighted图像上显示低信号强度,已被描述为易于发生攻击行为的病变。本研究旨在评估非典型血管瘤的行为。 材料和方法: 回顾 2012 年胸腰椎MRI报告对不典型血管瘤的诊断。由两名独立观察者复查图像,显示非典型椎体血管瘤并进行影像学或临床随访的病例纳入我们的研究。 结果: 在 2012 年期间在单个机构进行的 2784 例胸腰椎MR检查中,确定了 30 例具有随访数据的非典型血管瘤。影像学随访 23 个病灶 (平均随访 32 个月),其余 7 个病灶 (平均 43.6 个月) 有临床随访。22 个病灶在成像上稳定,而一个病灶在大约 6 年内表现出显著生长,形成典型血管瘤的MRI信号特征。11 个病灶的ct扫描显示血管瘤的典型特征。随访ct检查未能确定其中 2 处指标性病灶,显示脊柱外观正常。对其余 7 个病灶进行了临床随访; 没有患者报告指数病灶区域有症状。 结论: 不典型血管瘤是不常见的病变。我们人群中的病例没有表现出攻击行为。这些病变更合适的名称可能是低脂性血管瘤,以区别于侵袭性血管瘤。

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