|
静脉内平滑肌瘤病的影像学诊断
|
Abstract:
目的:探讨静脉内平滑肌瘤病(IVL)的影像学特点,以期提高该疾病的诊断水平。方法:回顾性分析我院经病理证实的12例IVL患者的影像学资料,分析其影像学特点。结果:12名患者均有子宫肌瘤病史,10例为首次发病,2例为复发。9例通过宫旁静脉–髂内静脉–髂总静脉的途径进入下腔静脉,其中又有2例通过下腔静脉进入右心房。3例通过左卵巢静脉–左肾静脉的途径进入下腔静脉,其中又有1例通过下腔静脉进入右心房。结论:表现为子宫肌瘤合并静脉、心包内占位的疾病应首先考虑IVL,影像学检查在该疾病的诊断、后续治疗中发挥着重要的作用。
Objective: To investigate the imaging features of intravenous leiomyomatosis (IVL) and to improve the diagnostic level of IVL. Methods: The imaging data of 12 patients with IVL confirmed by pathology in our hospital were retrospectively analyzed and their imaging characteristics were analyzed. Results: All 12 patients had a history of uterine fibroids, 10 cases were first onset and 2 cases were recurrence. 9 cases entered the inferior vena cava through the paracardiac vein, internal iliac vein and common iliac vein, and 2 cases entered the right atrium through the inferior vena cava. 3 cases entered the inferior vena cava through the left ovarian vein to the left renal vein, and 1 case entered the right atrium through the inferior vena cava. Conclusion: IVL should be considered first in patients with uterine fibroids complicated with venous and pericardium space occupying, and imaging examination plays an important role in the diagnosis and follow-up treatment of this disease.
[1] | Tierney, W.M., Ehrlich, C.E., Bailey, J.C., King, R.D., Roth, L.M. and Wann, L.S. (1980) Intravenous Leiomyomatosis of the Uterus with Extension into the Heart. The American Journal of Medicine, 69, 471-475.
https://doi.org/10.1016/0002-9343(80)90022-4 |
[2] | Lam, P.M., Lo, K.W., Yu, M.Y., et al. (2004) Intravenous Leiomyomatosis: Two Cases with Different Routes of Tumor Extension. Journal of Vascular Surgery, 39, 465-469. https://doi.org/10.1016/j.jvs.2003.08.012 |
[3] | 彭娴婧, 金征宇. 静脉内平滑肌瘤病的临床表现与影像学评估[J]. 中国医学科学院学报, 2010, 32(2): 179-184. |
[4] | 李忠信, 于淑靖. 多排螺旋CT诊断累及右侧心腔的静脉内平滑肌瘤病2例[J]. 中国临床医学影像杂志, 2008, 19(10): 757-758. |
[5] | Wang, H., Nie, P., Chen, B., et al. (2018) Contrast-Enhanced CT Findings of Intravenous Leiomyomatosis. Clinical Radiology, 73, 503.e1-503.e6. |
[6] | 张枢书, 张启川, 龚明福, 王晶晶. CT联合超声检查诊断侵犯右心系统的子宫静脉内平滑肌瘤病的价值[J]. 医学影像学杂志, 2019, 29(12): 4. |
[7] | 商建峰, 陈东, 方微, 等. 子宫静脉内平滑肌瘤病累及心脏的临床病理分析[J]. 中华病理学杂志, 2014, 43(6): 408-411. |
[8] | 钱海峰, 王青乐, 徐萍, 张惠美. 子宫静脉内平滑肌瘤病的多层螺旋CT表现及术前评估价值[J]. 浙江医学, 2015(5): 423-425. |
[9] | 虞奇跃. 原发性下腔静脉平滑肌肉瘤的CT诊断[J]. 医学影像学杂志, 2013, 23(12): 4. |
[10] | 李秀红, 仲海, 孙恒翠, 白秋云, 李斌. MSCT在静脉内平滑肌瘤中的应用价值. 医学影像学杂志, 2019, 29(8): 4. |