组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2018, Vol. 14 ›› Issue (2): 76-79.doi: 10.3969/j.issn.1673-0364.a474

• 论著 • 上一篇    下一篇

肥厚型葡萄酒色斑的影像学和病理学特点分析

朱佳芳，张紫旻，马刚，于文心，王天佑，蔡韧，林晓曦   

  1. 上海交通大学医学院附属第九人民医院整复外科；激光美容科；上海交通大学医学院附属第九人民医院影像科
  • 收稿日期:2018-01-10 修回日期:2018-03-12 发布日期:2020-07-23

Imaging and Pathological Characteristics of Port-Wine Stain with Facial Hypertrophy

ZHU Jiafang,ZHANG Zimin,MA Gang,YU Wenxin,WANG Tianyou,CAI Ren,LIN Xiaoxi   

  1. Department of Plastic and Reconstructive Surgery; Department of Laser and Aesthetic Medicine, Shanghai Jiaotong University School of Medicine; Department of Imaging, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine
  • Received:2018-01-10 Revised:2018-03-12 Published:2020-07-23
  • Contact: 国家自然科学基金青年项目(81602777)

摘要： 目的分析肥厚型葡萄酒色斑(Port-wine stains,PWS)的影像学和病理学特点,以期为改善该病的治疗效果提供依据。方法对32例接受过激光治疗的肥厚型PWS患者的面部MRI资料进行分析,对其增厚程度和血管畸形程度进行评价分级;对其中18例患者进行组织学检查,并与15例平坦型患者进行对比分析,探讨两种类型的血管组织学结构差异。结果 MRI资料的相关性分析证实,软组织厚度随畸形血管分布增多而增加(P<0.001)。组织学显示,肥厚型相较于平坦型PWS患者,其面部脂肪层和肌肉层的血管口径更大(0.048 mm vs 0.020 mm,P=0.004;0.035 mm vs 0.017 mm,P=0.008),并且管壁更厚(0.014 mm vs 0.006 mm,P=0.003;0.010 mm vs 0.006 mm,P=0.020)。结论肥厚型PWS患者激光疗效较差,与患者深部畸形血管明显超出现有激光对血管热凝固的破坏深度相关。

关键词: 葡萄酒色斑, 核磁共振, 组织病理学, 软组织增厚, 毛细血管畸形

Abstract: Objective To analyze the imaging and histopathologic characteristics of PWS patients with facial hyperplasia, in order to improve the therapeutic effect of the disease. Methods Thirty-two patients with facial hyperplasia treated by laser was retrospected. The degree of hyperplasia and the density of enhanced signals on T1-weighted MRI were graded using quartile scale. The pathological data of 18 cases was retrospectively analyzed and compared with 15 PWS patients without facial hyperplasia, to explore the histological difference. Results MRI results showed statistically significant correlation between the degree of hypertrophy and the density of enhanced signals (P<0.001). Histological features showed that vascular malformation existed not only in the dermis but also in the subcutaneous fat and muscle with much larger vessel diameters(0.048 mm vs 0.020 mm,P=0.004;0.035 mm vs 0.017 mm,P=0.008)and thicker vessel walls(0.014 mm vs 0.006 mm, P=0.003;0.010 mm vs 0.006 mm,P=0.020). Conclusion The involvement of the subcutaneous tissue by CM, which exceeds the damage depth of laser for blood vessels,might be one of the major cause of poor therapeutic effect with laser therapy.

Key words: Port-wine stains, Magnetic resonance imaging, Histopathology, Hypertrophy, Capillary malformation

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