甲下外生性骨疣超声表现
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摘要
目的观察甲下外生性骨疣的超声表现。方法回顾性分析9例经病理证实的甲下外生性骨疣患者的超声资料,观察病灶位置、回声、边界、形态、后方回声、与趾骨的关系及病灶内血流情况,并测量病灶大小。结果 9例甲下外生性骨疣均位于足趾,均为单发,右足5例、左足4例,第1趾8例、第4趾1例。9例患者的远节趾骨背侧甲床内均见边界清楚的线样强回声团块,最大径0.50～1.33cm、平均(0.86±0.29)cm,后方伴声影;团块均与远节趾骨相连,内部均无血流信号,趾骨连续性未见中断。受累趾甲甲床均增厚,2例合并嵌甲感染、1例合并甲沟炎患者的甲床内血流信号增多,余6例甲床内无异常血流信号。结论甲下外生性骨疣的超声表现有一定特异性,有助于诊断。
Objective To observe the ultrasonic manifestations of subungual exostosis.Methods Ultrasonic data of 9 cases with pathologically confirmed subungual exostosis after excision were retrospectively analyzed.The location,echo signal,boundary,morphology,posterior echogenicity and relationship with phalanx as well as blood flow of the lesions were observed.And the size of the lesion was detected.Results Solitarly lesion located on toe was detected in 9 patients,8 at the hallux and 1 at the fourth toe,5 at the right foot and 4 at the left foot.All lesions appeared as linear hyperechogenic mass with clear boundary and posterior acoustic shadowing located in the hyponychium of toes,with length from 0.50 cm to 1.33 cm and the average length of(0.86±0.29)cm,all connected with the distal phalanx with no interruption of bone continuity.No blood flow was detected in the mass.The hyponychium of the toe was thickened.Two cases with ingrown nail infection and 1 case with paronychia showed increased blood flow in the hyponychium,while other6 cases showed no abnormal blood flow in the hyponychium.Conclusion Subungual exostosis has some specific ultrasonic characteristics,which are helpful to the diagnosis of this disease.
Objective To observe the ultrasonic manifestations of subungual exostosis.Methods Ultrasonic data of 9 cases with pathologically confirmed subungual exostosis after excision were retrospectively analyzed.The location,echo signal,boundary,morphology,posterior echogenicity and relationship with phalanx as well as blood flow of the lesions were observed.And the size of the lesion was detected.Results Solitarly lesion located on toe was detected in 9 patients,8 at the hallux and 1 at the fourth toe,5 at the right foot and 4 at the left foot.All lesions appeared as linear hyperechogenic mass with clear boundary and posterior acoustic shadowing located in the hyponychium of toes,with length from 0.50 cm to 1.33 cm and the average length of(0.86±0.29)cm,all connected with the distal phalanx with no interruption of bone continuity.No blood flow was detected in the mass.The hyponychium of the toe was thickened.Two cases with ingrown nail infection and 1 case with paronychia showed increased blood flow in the hyponychium,while other6 cases showed no abnormal blood flow in the hyponychium.Conclusion Subungual exostosis has some specific ultrasonic characteristics,which are helpful to the diagnosis of this disease.
引文
[1] Calligaris L,Berti I.Subungual exostosis.J Pediatr,2014,165(2):412.
[2] Baek HJ, Lee SJ, Cho KH, et al. Subungual tumors:Clinicopathologic correlation with US and MR imaging findings.Radiographics,2010,30(6):1621-1636.
[3] Ferri-de-Barros F.Subungual exostosis of the toes:A systematic review.Clin Orthop Relat Res,2014,472(4):1251-1259.
[4] Malkoc M,Korkmaz O,Keskinbora M,et al.Surgical treatment of nail bed subungual exostosis.Singapore Med J,2016,57(11):630-633.
[5] Wortsman X,Wortsman J,Soto R,et al.Benign tumors and pseudotumors of the nail:A novel application of sonography.J Ultrasound Med,2010,29(5):803-816.
[6]田保玲,孙春煜,高霭峰,等.甲下外生性骨疣的临床病理分析.中国组织化学与细胞化学杂志,2012,21(6):584-586.
[7]施琳,蒋智铭,张惠箴,等.甲下外生性骨疣的临床病理特征.临床与实验病理学杂志,2008,24(3):323-326.
[8]赵建红,刘宇,王刚,等.甲下外生性骨疣.临床皮肤科杂志,2017,46(4):219-221.
[9] Piccolo V,Argenziano G,Alessandrini AM,et al.Dermoscopy of subungual exostosis:A retrospective study of 10 patients.Dermatology,2017,233(1):80-85.
[10] Chiang YP, Hsu CY,Lien WC,et al. Ultprasonographic appearance of subungual glomus tumors.J Clin Ultrasound,2014,42(6):336-340.
[11] Lee SK,Jung MS,Lee YH,et al.Two distinctive subungual pathologies:Subungual exostosis and subungual osteochondroma.Foot Ankle Int,2007,28(5):595-601.
[12] Goktay F,Atis G,Gunes P,et al.Subungual exostosis and subungual osteochondromas:A description of 25cases.Int J Dermatol,2018,57(7):872-881.
[13]郭林,王植,宫可同,等.手部骨肿瘤和肿瘤样病变的影像学诊断及鉴别诊断.中国中西医结合外科杂志,2017,23(3):323-326.
[2] Baek HJ, Lee SJ, Cho KH, et al. Subungual tumors:Clinicopathologic correlation with US and MR imaging findings.Radiographics,2010,30(6):1621-1636.
[3] Ferri-de-Barros F.Subungual exostosis of the toes:A systematic review.Clin Orthop Relat Res,2014,472(4):1251-1259.
[4] Malkoc M,Korkmaz O,Keskinbora M,et al.Surgical treatment of nail bed subungual exostosis.Singapore Med J,2016,57(11):630-633.
[5] Wortsman X,Wortsman J,Soto R,et al.Benign tumors and pseudotumors of the nail:A novel application of sonography.J Ultrasound Med,2010,29(5):803-816.
[6]田保玲,孙春煜,高霭峰,等.甲下外生性骨疣的临床病理分析.中国组织化学与细胞化学杂志,2012,21(6):584-586.
[7]施琳,蒋智铭,张惠箴,等.甲下外生性骨疣的临床病理特征.临床与实验病理学杂志,2008,24(3):323-326.
[8]赵建红,刘宇,王刚,等.甲下外生性骨疣.临床皮肤科杂志,2017,46(4):219-221.
[9] Piccolo V,Argenziano G,Alessandrini AM,et al.Dermoscopy of subungual exostosis:A retrospective study of 10 patients.Dermatology,2017,233(1):80-85.
[10] Chiang YP, Hsu CY,Lien WC,et al. Ultprasonographic appearance of subungual glomus tumors.J Clin Ultrasound,2014,42(6):336-340.
[11] Lee SK,Jung MS,Lee YH,et al.Two distinctive subungual pathologies:Subungual exostosis and subungual osteochondroma.Foot Ankle Int,2007,28(5):595-601.
[12] Goktay F,Atis G,Gunes P,et al.Subungual exostosis and subungual osteochondromas:A description of 25cases.Int J Dermatol,2018,57(7):872-881.
[13]郭林,王植,宫可同,等.手部骨肿瘤和肿瘤样病变的影像学诊断及鉴别诊断.中国中西医结合外科杂志,2017,23(3):323-326.