脛骨旁腫瘤於軟組織超音波檢查下之鏡像假影：病例報告

軟組織病灶超音波檢查的鏡像假影在日常操作中偶有發現，但文獻探討與報告並不多見。本篇報告一位罹患脛骨前未分化形肉瘤的70歲女性，起初在超音波檢查中發現疑似骨頭侵入的卵形病灶影像，經核磁造影檢查後顯示真實腫瘤僅及於脛骨外部圓頂形的區塊，骨內影像為完善對稱之鏡像假影，同時脛骨邊緣相當平整。雖然經腫瘤切除與病理檢查後仍判定為惡性腫瘤，目前經化療和電療治療中。雖然對腫瘤良惡性鑑別助益有限，但此完整、具誤導性的超音波鏡像假影仍值得探討，我們希望藉由此一報告來提醒臨床醫師相關可能性，供診療上參考。

關鍵字

超音波軟組織檢查；鏡像假影

並列摘要

Although mirror-image artifacts of soft tissue sonography are not common, they produce phantom pictures and may lead to misdiagnosis. Relevant literature on mirror-image artifacts, even case reports, are rare. We described a 70-year-old female initially having a painless, immovable nodule with an insidious onset on her right anterior middle leg. After she received an initial physical examination and a radiographic approach, musculoskeletal sonography disclosed an oval non-compressible hypoechoic tumor, which seemed to invade the bony cortex medial to her tibia crest. A real, dome-shaped tumor above the tibia bone with an intraosseous mirror-image artifact was detected after MRI study, and the bony cortex appeared to be quite intact. After she was transferred to the orthopedic division, undifferentiated pleomorphic sarcoma was diagnosed using tissue biopsy and a complete excision of the tumor was performed smoothly. Thus far, 30 fractions of radiotherapy and 5 courses of chemotherapy have been completed. This case report reacquaints clinicians with this vivid, misleading mirror-image artifact, which deserves further study and discussion.

並列關鍵字

soft tissue sonography ； mirror-image artifact

延伸閱讀

Chang, H. W., Shu, Y. T., Chang, C. Y., & Lai, Y. J. (2009). 脛骨的去分化型軟骨肉瘤併膝痛：病例報告. 內科學誌, 20(2), 181-186. https://doi.org/10.6314/JIMT.2009.20(2).11
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Chen, L., & Tsai, C. (1988). 脛骨骨樣骨瘤之電腦斷層攝影. 中華放射線醫學雜誌, 13(4), 433-437. https://www.airitilibrary.com/Article/Detail?DocID=10188940-198812-13-4-433-437-a
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脛骨旁腫瘤於軟組織超音波檢查下之鏡像假影：病例報告

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