DOI QR코드

DOI QR Code

외상성 신경종을 닮은 정중신경 내 모세혈관종의 초음파 및 자기공명영상 소견: 증례 보고

Ultrasound and MRI Findings of Intraneural Capillary Hemangioma of the Median Nerve Mimicking Traumatic Neuroma: A Case Report

  • 송한별 (대구가톨릭대학교 의과대학 영상의학교실) ;
  • 이영환 (대구가톨릭대학교 의과대학 영상의학교실) ;
  • 강웅래 (대구가톨릭대학교 의과대학 영상의학교실) ;
  • 이성문 (대경영상의학과의원) ;
  • 채승범 (대구가톨릭대학교 의과대학 정형외과학교실)
  • Song, Han Byeul (Department of Radiology, School of Medicine, Catholic University of Daegu) ;
  • Lee, Young Hwan (Department of Radiology, School of Medicine, Catholic University of Daegu) ;
  • Kang, Ung Rae (Department of Radiology, School of Medicine, Catholic University of Daegu) ;
  • Lee, Sung Moon (Daekyung Imaging Center) ;
  • Chae, Seung Bum (Department of Orthopedic Surgery, School of Medicine, Catholic University of Daegu)
  • 투고 : 2017.04.11
  • 심사 : 2017.09.25
  • 발행 : 2018.02.01

초록

정중신경 내 혈관종은 매우 드물며, 적은 수의 증례만이 보고되어 있다. 저자들은 38세 남자환자에서 생긴 정중신경 내 모세혈관종의 초음파 및 자기공명영상 소견을 보고한다. 환자는 손목 바닥 부위에 만져지는 작은 종괴와 손목굴증후군 증상으로 내원하였다. 초음파검사에서 혈류증가를 동반하지 않는 침윤성 신경 내 종괴가 보였고, 저자들은 연속성 신경종으로 오인하였다. 종괴는 T2강조영상에서 불균질하지만 전체적으로 고신호강도를 보였으며, 불균질하지만 조영증강이 잘되는 소견을 보였고, 이러한 자기공명영상 소견은 영상소견을 재검토 하였을 때 모세혈관종을 올바르게 진단하는 데 도움이 되는 소견으로 생각된다.

Intraneural hemangioma of the median nerve is extremely rare. Only a few cases have been reported in literature. The researchers present ultrasound (US) and MRI findings of a case of 38-year-old-man with intraneural capillary hemangioma of the median nerve. The patient had a small, palpable mass in the volar aspect of the wrist and symptoms of carpal tunnel syndrome. US showed an infiltrative intraneural mass, without significant blood flow despite a compression test. The researchers initially misdiagnosed this mass as an in-continuity neuroma. The mass showed heterogeneous, but predominantly high signal intensity on T2-weighted image, as well as heterogeneous enhancement. The MRI findings were helpful for correct diagnosis on the retrospective review.

키워드

참고문헌

  1. Vekris MD, Stafilas KS, Zacharis KX, Xenakis TA, Soucacos PN, Beris AE. Intrinsic haemangioma of the median nerve: report of a case and review of the literature. Microsurgery 2008;28:89-90 https://doi.org/10.1002/micr.20456
  2. Prosser AJ, Burke FD. Haemangioma of the median nerve associated with Raynaud's phenomenon. J Hand Surg Br 1987;12:227-228 https://doi.org/10.1016/S0363-5023(87)80276-9
  3. Rousie M, Ledoux P. Intraneural hemangioma: a rare cause of intermittent carpal tunnel syndrome. Chir Main 2015; 34:322-323 https://doi.org/10.1016/j.main.2015.08.009
  4. Kerimoglu U, Uzumcugil A, Yilmaz G, Ayvaz M, Leblebicioglu G, Altinok G. Intraneural hemangioma of digital nerve diagnosed with MR imaging. Skeletal Radiol 2007;36:157-160
  5. Mestdagh H, Lecomte-Houcke M, Reyford H. Intraneural haemangioma of the posterior tibial nerve. J Bone Joint Surg Br 1990;72:323-324
  6. Brand C, Pedro MT, Schick M, Scheuerle A, Scheglmann K, Wirtz CR, et al. [Intraneural hemangioma of the ulnar nerve]. Nervenarzt 2015;86:197-201 https://doi.org/10.1007/s00115-014-4169-5
  7. Woertler K. Tumors and tumor-like lesions of peripheral nerves. Semin Musculoskelet Radiol 2010;14:547-558 https://doi.org/10.1055/s-0030-1268073
  8. Depaoli R, Coscia DR, Alessandrino F. In-continuity neuroma of the median nerve after surgical release for carpal tunnel syndrome: case report. J Ultrasound 2014;18:83-85
  9. Daoud A, Olivieri B, Feinberg D, Betancourt M, Bockelman B. Soft tissue hemangioma with osseous extension: a case report and review of the literature. Skeletal Radiol 2015;44: 597-603 https://doi.org/10.1007/s00256-014-2017-0
  10. Flors L, Leiva-Salinas C, Maged IM, Norton PT, Matsumoto AH, Angle JF, et al. MR imaging of soft-tissue vascular malformations: diagnosis, classification, and therapy follow-up. Radiographics 2011;31:1321-1340; discussion 1340-1341 https://doi.org/10.1148/rg.315105213

피인용 문헌

  1. Intraneural hemangioma in Klippel-Trenaunay syndrome: role of musculo-skeletal ultrasound in diagnosis-case report and review of the literature vol.23, pp.3, 2018, https://doi.org/10.1007/s40477-020-00434-1