軟組織腫瘤之超音波檢查

Ultrasonographic Assessment of Soft-Tissue Tumors

由於高解析度超音波，近年來逐漸被廣泛運用來檢查表淺軟組織腫瘤。是一種非侵襲性、即時性、動態、便宜而且迅速的檢查。我們收集87例軟組織腫瘤，在接受外科手術或穿刺取得病理組織，或接受血管攝影檢查以確定診斷之前，利用高解析度超音波配合彩色都卜勒檢查。我們記錄其回音特色、大小、位置、形狀、邊緣清晰度、及血流情況，並記錄其病史。結果發現根據其回音特色，可輕易地分出22例水囊類及65例實體類腫瘤。比對超音波診斷與病理結果，發現超音波檢查確實可分出水囊類及實體類腫瘤；而超音波檢查在對於惡性實體類腫瘤診斷之敏感度、特異性及陽性預測值，分別為80%、100%及100%。高解析度超音波雖然無法精確地診斷腫瘤的病理變化，但它可以分出水囊類及實體類腫瘤，並配合腫瘤的位置、大小、血流分佈及邊緣情況，應可幫助臨床上對軟組織腫瘤的診斷。

In recent years, high-resolution ultrasonography has been increasingly to examine superficial soft-tissue masses. This trend is attributable to its characteristics of non-invasiveness, real-time data acquisition, time savings compared to other imaging techniques such as MRI and CT, and good ability to detect vascularity on color Doppler sonography. Its cost-effectiveness and increasing availability have made it even more popular for clinical use. We examined the echogenic characteristics of 87 soft-tissue masses classified as either cystic (n=22) or solid (n=65) masses. The size, margin, shape, and vascularity of the masses were recorded simultaneously. The pathology of each masses was confirmed by excisional biopsy, needle biopsy, or angiography. The sensitivity, specificity, and positive predictive value of high-resolution ultrasonography with color Doppler examination to differentiate with between benign and malignant solid soft-tissue tumors were 80%, 100%, and 100%, respectiviely. Although high-resolution ultrasonography cannot accurately confirm the pathology of soft-tissue masses, it can easily detect the existence of cystic or solid masses. It can also disclose the location, size, blood flow pattern, and anatomic relationship between the mass and adjacent structures. Therefore, it is a good tool for use in the diagnosis of soft-tissue masses and provides a better basis for monitoring the effects of treatment.