小心假扮「黑青」的「假性血管瘤」！受傷腫痛後別大意！

今天來分享一個手臂刺傷後的驚人超音波影像！你的瘀血和腫塊可能不只是傷後的血腫！
Today I want to share a series of ultrasound images of an arm after being punctured. This case tells us that the ecchymosis and swelling may not merely be a hematoma.

患者來看的時候，手臂除了瘀血外還有明顯的腫脹，在臂彎處還有一個鴿子蛋大小的硬塊。在腫塊的表面有一個疤痕，據說是被扎傷的結果。
The arm was quite swollen when I saw it. A solid mass could be palpated. There was a spheric scar on the top of the mass. It was said to be the puncture site. 

超音波下可以清楚看到一個橢圓形的囊狀構造大小約為2.2公分 x 1.4公分 x 1.3公分。裡面有一些雲霧狀的內容物一陣陣地翻騰著。這個囊狀構造跟旁邊的血管（臂動脈）相連，因為血液不斷注入囊內，產生了渦流。這個囊的表面不像有明顯的血管壁。
Under the ultrasound image, a large cystic lesion could be clearly seen, which is about 22 mm x 14 mm x 13 mm in size. There seemed to be some cloudy, whirling content within. The cyst has a stalk connecting to an adjacent artery(brachial a.). The whirling turbulence was produced by the blood projected into the cyst. There is no obvious vessel wall around the cystic lesion. 

在都普勒模式下，從血管噴射到囊內的血流可以透過紅藍顏色被清楚觀察到。因渦流產生的相反方向血流，在都普勒模式下形成太極一樣的圖案。
Under the Doppler mode, blood flow projection from the artery into the cystic lesion and the turbulence within the cyst can be objected. Different colors refer to opposite flow direction, which mimic the shape of a Tai-chi symbol.

經驗豐富的你可能也猜到了，這是一個假性動脈瘤！對於非醫療背景的朋友們，希望能透過這個案例告訴大家，你的傷害可能不止表面看起來那麼單純！超音波能幫助你更了解自己的傷，在皮膚之下到底發生了什麼事！
You might have had the answer now. Yes, it is a pseudo-aneurysm.