平阳霉素治疗小儿海绵状血管瘤的疗效分析

目的:评价平阳霉素瘤内注射治疗小儿海绵状血管瘤的临床疗效。方法:回顾性分析234例海绵状血管瘤常规瘤体内注射平阳霉素(注射次数1次-6次)后的临床资料。结果:经过3年随访,治愈168例,基本治愈12例,好转45例,无效9例。总有效率96.15%。结论:平阳霉素瘤内注射治疗海绵状血管瘤疗效高,疗程短,是一种简便、安全的有效方法。     

平阳霉素治疗小儿海绵状血管瘤的疗效分析

目的:评价平阳霉素瘤内注射治疗小儿海绵状血管瘤的临床疗效.方法:回顾性分析234例海绵状血管瘤常规瘤体内注射平阳霉素(注射次数1次～6次)后的临床资料.结果:经过3年随访,治愈168例,基本治愈12例,好转45例,无效9例.总有效率96.15%.结论:平阳霉素瘤内注射治疗海绵状血管瘤疗效高,疗程短,是一种简便、安全的有效方法.     

平阳霉素治疗小儿浅表血管瘤的观察及护理

目的：探讨平阳霉素瘤体内注射治疗小儿血管瘤的护理对策。方法：对468例小儿血管瘤患者平阳霉素瘤体内注射进行观察评估及护理干预。结果：468例小儿血管瘤患者,治愈336例,基本治愈24例,好转90例,无效18例,总有效率96．15％。结论：平阳霉素瘤体内注射治疗小儿浅表血管瘤安全、有效,护理得当会取得满意效果     

经肝动脉栓塞治疗肝海绵状血管瘤（附26例）

目的：观察经肝动脉栓塞治疗肝海绵状血管瘤的临床疗效和安全性。方法：对26例肝海绵状血管瘤经股动脉或左锁骨下动脉入路插管,超选择至肿瘤供血动脉,采用平阳霉素与无水乙醇或碘化油、明胶海绵进行栓塞治疗,1年内随访疗效及不良反应。结果：26例患者介入治疗成功率100％,肿瘤完全消失者6例,瘤体缩小〉50％者17例,瘤体缩小不足50％者2例,瘤体无变化者1例,无瘤体进展者;总有效率为95．1％;所有患者未出现严重并发症。结论：经肝动脉栓塞治疗肝海绵状血管瘤是一种安全、简便、有效的方法。     

平阳霉素治疗头颈部血管瘤132例临床分析

目的总结平阳霉素瘤内注射治疗头颈部各种血管瘤的疗效。方法收集我科自1996年3月至2003年12月以平阳霉素注射治疗头颈部毛细血管型、海绵状及混合性等血管瘤132例(155个瘤体)的临床资料进行分析。结果经过6个月～8年随访，治愈和基本治愈率为82．57％，好转11．36％，总有效率为93．93％。毛细血管型、海绵状和混合性血管瘤的治愈和基本治愈率分别为84．0％、88．5％、76．1％。发热反应为8．33％。结论平阳霉素治疗毛细血管型、海绵状和混合性血管瘤疗效高，疗程短，是一种简便、安全有效的方法。     

平阳霉素注射和手术切除治疗口腔颌面部海绵状血管瘤

目的探讨平阳霉素注射加手术切除治疗口腔颌面部海绵状血管瘤的效果。方法将8mg平阳霉素用1％利多卡因4mL充分溶解,后注射于瘤体周边或根部,以及瘤腔间缘的多处软组织内,注射时应尽可能地增加药物作用的有效面积,以注射到瘤体表面及周边组织轻微苍白肿胀为佳。每次注射的药物量应根据患者的年龄、瘤体的大小、部位等因素来决定,最多不超过8mg,每隔2wk重复注射1次,直至肿瘤消失或明显缩小。对于见效慢的或经过4次注射已明显缩小至直径lcm以下的,则采用手术切除的方法,以缩短治疗周期。结果本组共诊治23例口腔颌面部海绵状血管瘤患者中经平阳霉素局部注射治愈17例,这些被治愈的患者在治疗期间除出现轻度的胃肠道不适及发低热外,均未出现明显的不良反应,另5例显效和有效的病例最终都由手术完整切除。本组病例均经随访1-2a未见复发。结论平阳霉素注射加手术切除治疗口腔颌面部海绵状血管瘤,其方法安全、简便,效果稳定、良好,可在一般医院口腔科推广应用。     

口腔颌面部126例海绵状血管瘤缝扎硬化的疗效分析

目的 观察瘤体分区缝扎硬化治疗颌面部血管瘤的疗效及不良反应。方法 采用瘤体周围及分区交叉缝扎加瘤腔内注射平阳霉素的方法，治疗颌面部海绵状血管瘤126例。平阳霉素术后可重复注射1～6次。结果 随访观察6-36个月，治愈98例，基本治愈26例，有效2例，无无效病例。临床治愈率(包括治愈和基本治愈)为98．4％。结论 分区缝扎硬化治疗海绵状血管瘤操作简便、安全可靠，治愈率高，特别对于唇部、舌前部、颊部易于阻断血流处治疗效果好，具有较好的治疗应用价值。     

口腔颌面部126例海绵状血管瘤缝扎硬化的疗效分析

目的　观察瘤体分区缝扎硬化治疗颌面部血管瘤的疗效及不良反应。方法　采用瘤体周围及分区交叉缝扎加瘤腔内注射平阳霉素的方法,治疗颌面部海绵状血管瘤12 6例。平阳霉素术后可重复注射1～6次。结果　随访观察6～3 6个月,治愈98例,基本治愈2 6例,有效2例,无无效病例。临床治愈率(包括治愈和基本治愈)为98 4%。结论　分区缝扎硬化治疗海绵状血管瘤操作简便、安全可靠,治愈率高,特别对于唇部、舌前部、颊部易于阻断血流处治疗效果好,具有较好的治疗应用价值。     

经肝动脉栓塞治疗肝海绵状血管瘤(附26例)

目的:观察经肝动脉栓塞治疗肝海绵状血管瘤的临床疗效和安全性.方法:对26例肝海绵状血管瘤经股动脉或左锁骨下动脉入路插管,超选择至肿瘤供血动脉,采用平阳霉素与无水乙醇或碘化油、明胶海绵进行栓塞治疗,1年内随访疗效及不良反应.结果:26例患者介入治疗成功率100%,肿瘤完全消失者6例,瘤体缩小＞50%者17例,瘤体缩小不足50%者2例,瘤体无变化者 1例,无瘤体进展者;总有效率为95.1%;所有患者未出现严重并发症.结论:经肝动脉栓塞治疗肝海绵状血管瘤是一种安全、简便、有效的方法.     

平阳星与平阳霉素治疗血管瘤和淋巴管瘤的对照分析

采用平阳霉素病变内注射治疗血管瘤和淋巴管瘤目前已有许多报告,其确切的疗效和优点已为许多学者所论述,但随着治疗病例的增加也出现了某些副反应,有的甚至是严重的。我们自1996年开始应用平阳星（平阳霉素的纯品）瘤内注射治疗血管瘤和淋巴管瘤,避免了很多平阳霉素治疗的不良反应。为评价这一新药,今对两组病例进行回顾性对照分析。1 材料与方法1．1 临床资料1986年6月～2000年6月我院采用平阳霉素和平阳星共治疗血管瘤、淋巴管瘤1 960例,其中获随访半年以上的患者1 835例,平阳霉素治疗组925例（1 019个瘤体）,平阳星治疗组910例（…     

小肝肿瘤的诊断和术中定位

本文复习经B型超声、CT及AFP诊为小肝肿瘤36侧,内肝细胞癌23例,海绵状血管瘤11例,转移癌2例。肿瘤最大径<3cm者14例,3—5cm22例,位于右肝叶22例,左肝叶14例。 CT对肝细胞癌和肝转移癌的诊断准确率为100％,对肝海绵状血管瘤的准确率为72.7％;B型超声为81.8％。AFP在23例肝细胞癌的阳性率为66.6％。 本文介绍了在术中不能看见或不能触到的小肝肿瘤的寻找方法,7例由此发现而顺利作了切除术,计肝细胞癌4例,海绵状血管瘤2例,转移癌1例。     

Continuous low-dose-rate radiation of radionuclide phosphorus-32 for hemangiomas

The study goal was to clarify the therapeutic effect and the absorbed dose of radionuclide phosphorus-32 for skin hemangiomas and the consequent risk of side effects in these patients. Phosphorus-32 is an β emitter and is used for skin hemangioma treatment. In comparison with the few Gy per minute of the linear accelerators, the dose rate of phosphorus-32 for hemangiomas is much <1 Gy/hour; so, the latter is called low-dose-rate radiation. To achieve the therapeutic dose, continuous hours or days of radiation is necessary. For strawberry hemangiomas, the phosphorus-32 applicator was tightly placed on the lesion site for several hours until reaching therapeutic dose. The absorbed dose was estimated by radiochromic films. The absorbed dose of phosphorus-32 irradiation declined exponentially with a depth from 0 to 2.5 mm. Of the 316 patients with strawberry hemangiomas, the lesion disappeared completely within 3 months after one-time treatment in 259 cases (82%). For cavernous hemangiomas, 370KBq phosphorus-32 colloid was injected into the hemangioma each square centimeter, and the absorbed radiation was estimated by theoretical calculation. Forty-two of the 58 patients with cavernous hemangiomas (72%) had lesions that completely disappeared within 3 months after receiving one to six treatments. Thus, the phosphorus-32 for strawberry hemangiomas and the chromium phosphate-32 colloid for cavernous hemangiomas were clearly efficacious.     

肝海绵状血管瘤二种手术方式的选用体会

Objective: To investigate the optimizing of operative techniques on cavernous hepatic hemangioma by compar-ing the effective of the two approaches (enucleation and hepatectomy). Methods: From May 1994 to September 2006, forty-three patients underwent the surgical removal of the cavernous hepatic hemangioma were analyzed retrospectively. Enucle-ation was used for 16 cases and hepatectomy for 27 cases. The relative clinical data and operative factors between the two operative techniques were compared. Results: Statistically significant differences in tumor size, location and intraoperative blood lose between the two groups were observed (P < 0.05 ). Although enucleation was associated with less intraoperative bleeding and transfusion requirement but no significant differences in postoperative liver functional parameter, complication and length of hospital stay were observed. Conclusion: With proper choice, enucleation and hepatectomy both are effective treatments for cavernous hepatic hemangiomas.     

The role of stereotactic radiosurgery in cavernous sinus hemangiomas: a systematic review and meta-analysis

Cavernous sinus hemangioma is a rare and complex vascular tumor. A direct microsurgical approach usually results in massive hemorrhage. Stereotactic radiosurgery has emerged as a treatment alternative to microsurgery. To conduct a meta-analysis assessing the effect and complications of stereotactic radiosurgery in cavernous sinus hemangioma, a systematic review and meta-analysis of all cases of cavernous hemangioma in the cavernous sinus treated with stereotactic radiosurgery was performed. The search revealed ten papers with a total enrollment of 59 patients. Tumor size ranged from 1.5–51.4 cm³ (mean 9.6 cm³). The mean follow-up period was 49.2 months (range 6–156 months). The most recent MR images demonstrated remarkable tumor shrinkage in 40 patients (67.8%), partial shrinkage in 15 patients (25.4%), and no change in four patients (6.8%). There was no significant correlation between lesion volume and tumor shrinkage. Patients with remarkable tumor shrinkage received higher doses than those with partial or no change tumor shrinkage (P = 0.031). Thirteen patients (22.0%) had no cranial nerve impairments before stereotactic radiosurgery. Among those 46 patients with cranial nerve impairments before stereotactic radiosurgery, complete resolution was achieved in seven patients and improvement in 28, and these impairments remained essentially unchanged in 11 patients. Only one patient had additional trigeminal nerve disturbance. There is no statistical significance in tumor control between patients treated with or without surgery (P = 0.091). The meta-analysis suggests stereotactic radiosurgery avoids the complications associated with attempted microsurgical resection. Stereotactic radiosurgery is an alternative for cavernous sinus hemangiomas confirmed by typical imaging.     

Technetium-99m Radiocolloid Scintigraphy,Planar and SPECT Red Blood Cell Imaging and Ultrasonography in Diagnosis of Hepatic Hemangioma

Technetium-99m planar sulfur colloid scintigraphy, red blood cell imaging and ultrasonography were performed in eighteen patients of hepatic hemangioma to evaluate their diagnostic utility. Radiocolloid scans detected fourteen hemangiomas in 12 patients as focal hepatic defects but missed 9 lesions smaller than 2.5cm in the other 6 patients, accounting for a 61% sensitivity. All 23 lesions were avascular or normovascular on radionuclide flow study. Serial planar red blood cell scintigraphy showed characteristic gradually increasing focal isotopic accumulation in the 14 hemangiomas which had identifiable cold areas on the radiocolloid study. One of 6 patients with normal radiocolloid scan also showed the typical increasing blood pool pattern of hemangioma, five had normal planar scans till 11/2 hours. SPECT red blood cell imaging in these 5 patients detected an additional seven hemangiomas. All 7 lesions were smaller than 2.5cm. One 1.5cm hemangioma was missed on both planar and SPECT red blood cell imaging. Region of interest ratios in SPECT transaxial images confirmed gradually increasing concentration of labeled red blood cells in the lesions. Ultrasonography detected 22 of the 23 hemangiomas. Ten were hyperechoic, average size 2.25cm. Twelve were of mixed pattern, generally larger, average size 7.2cm. Sonography is useful in the detection of hepatic hemangiomas as a focal mass lesion, but the variable sonographic appearance precludes a definite pathological diagnosis. Technetium-99m red blood cell imaging appears a sensitive technique in detection of hepatic hemangioma, with SPECT being especially useful in locating smaller lesions. The addition of SPECT to planar red blood cell imaging considerably improves the sensitivity of this highly specific technique for an accurate non-invasive diagnosis in hepatic hemangioma.     

A case of multiple cavernous hemangiomas of the lung

A case of multiple cavernous hemangiomas of the lung is presented. A 61-year-old woman was suffering from mitral stenosis and insufficiency. On the chest roentgenogram, multiple tumor shadows were revealed at all the lobes of the lung. She had been followed up for about 10 years under the diagnosis of the metastatic carcinoma of the lung. But no tumor lesion had been found at any other organs. Throughout this period, the tumor shadows had not changed in size or number. She died of congestive heart failure, and an autopsy was performed. Histologically, the tumors were diagnosed as cavernous hemangiomas and differentiated from arteriovenous fistula or sclerosing hemangioma.     

Natural course of cavernous hepatic hemangioma

Cavernous hepatic hemangiomas are benign liver tumors and present as incidental findings on sonographic examinations, but little is known concerning their natural course. Therefore, we performed a clinical and imaging follow-up of 64 cases of cavernous hepatic hemangioma in 50 patients during an average 18.8 month period. One case presented a symptom of slightly right upper quadrant pain and two cases showed thrombocytopenia. In one of the thrombocytopenia cases, cavernous hepatic hemangioma was resected because of Kasabach-Merrit syndrome. No case increased in size during follow-up, but one case decreased and disappeared. These results suggested that prolonged clinical and imaging follow-up of cavernous hepatic hemangiomas may be needed.     

Hemangioma of the urinary bladder.

BACKGROUND: Hemangioma of the urinary bladder is rare and the long term outcome of patients is unknown. METHODS: The authors evaluated the clinical and pathologic findings in 19 patients with a vesical hemangioma. All patients were treated at the Mayo Clinic between 1932-1998 and had histologic confirmation of the diagnosis. Hemangioma was classified into cavernous, capillary, or arteriovenous types based on conventional criteria from other sites. Clinical information was obtained from chart review. The mean follow-up of the patients was 6.9 years (range, 0.3-25 years). RESULTS: The mean patient age at the time of diagnosis was 58 years (range, 19-76 years) and the male-to-female ratio was 3.7:1. Patients typically presented with macroscopic hematuria and endoscopic findings usually were nonspecific. The diagnosis of hemangioma was suspected in 3 patients (16%) prior to biopsy. There was a predilection for the posterior and lateral walls and the tumor usually was small (range, 0.2-3 cm; median, 0.7 cm) and solitary. The histologic types of hemangioma were cavernous (15 cases), capillary (2 cases), and arteriovenous (2 cases). All patients were treated with biopsy with or without fulguration, except for one patient who was treated with a partial cystectomy. No patients developed a recurrence during a mean follow-up of 6.9 years. CONCLUSIONS: Patients with hemangioma of the urinary bladder have a favorable outcome. Biopsy and fulguration are effective for hemangioma of the bladder when the lesion is small.     

软组织血管瘤的影像诊断

目的:研究软组织血管瘤的X线平片、CT 和MRI 征象,探讨CT 和MRI对该肿瘤的诊断价值。方法:对经手术病理或临床确诊的软组织血管瘤35例进行回顾性分析。所有病例均行X线平片、CT平扫和增强扫描。其中动态增强扫描8例,MRI检查15例。结果:海绵状血管瘤19例,蔓状血管瘤8例,毛细血管瘤3例,混合型血管瘤2 例,血管瘤病3例。CT平扫肿瘤呈结节状、分叶状、管状或团块状低密度病变。增强扫描后血管成分显著强化,可呈扭曲血管状,而非血管成分不强化或轻度强化。MRIT1WI上肿瘤呈略高信号或等信号,T2WI上呈显著高信号,其中夹杂不均匀信号,病理上代表了脂肪、纤维组织、平滑肌、血栓、静脉石和钙化。结论:CT和MRI对血管瘤均可作出定性诊断,但MRI在显示血管瘤内特征性的血管及血管成分间的脂肪纤维组织方面较CT优越。