子宫平滑肌瘤病经静脉延伸至右侧心腔的影像学诊断  

The image diagnosis of uterine leiomyomatosis extending through the inferior vena cava into the right cardiac cavities

作　　者：支爱华[1] 戴汝平[1] 蒋世良[1] 黄连军[1] 张岩[1] 赵红[2] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院放射科,北京100037 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院病理科,北京100037

出　　处：《中华放射学杂志》2005年第3期275-279,共5页Chinese Journal of Radiology

摘　　要：目的探讨子宫平滑肌瘤病经静脉延伸至右侧心腔的影像学特点及诊断。方法对5例子宫平滑肌瘤病经静脉延伸至右侧心腔的病例进行回顾分析,5例均行胸部X线平片、超声心动图,3例行电子束CT(EBCT)检查,2例行MRI和DSA检查。结果3例行EBCT检查者中2例诊断为子宫平滑肌瘤(肉瘤可能),肿瘤经静脉延伸至右侧心腔并侵及肺动脉(1例病理诊断为子宫平滑肌瘤病,1例未手术),另1例诊断为子宫平滑肌瘤经静脉延伸至右侧心腔(未手术);2例行MR和DSA检查诊断为子宫平滑肌瘤经静脉延伸至右侧心腔。5例患者中3例病理诊断为平滑肌瘤病。结论子宫平滑肌肿瘤可以经静脉延伸至右侧心腔,罕见,称为子宫平滑肌瘤病,临床有一定特点。CT、MRI、DSA有相应的征象,影像学表现常呈生物学恶性征象,但积极手术治疗仍可得到良好临床效果。Objective To explore the clinical and image features of uterine leiomyomatosis extending through the inferior vena cava (IVC) into the right cardiac cavities. Methods A retrospective study was performed in 5 patients with uterine leiomyomatosis extending through IVC into the right cardiac cavities. All 5 cases underwent the examination of chest X-ray and UCG. 3 patients underwent the examination of EBCT. 2 patients underwent the examination of MRI and angiography. Results Uterine leiomyosarcoma extending through IVC into the right cardiac cavities was diagnosed in 2 patients and uterine leiomyomatosis extending through IVC into the right cardiac cavities was diagnosed in 1 case on EBCT. Uterine leiomyomatosis extending through IVC into the right cardiac cavities was diagnosed in 2 patients on MRI and angiography. In 3 of the 5 patients, the diagnosis of uterine leiomyomatosis was demonstrated by surgery-pathology. Conclusion Uterine leiomyoma extending through IVC into the right cardiac cavities is rare, and this situation is called uterine leiomyomatosis. Clinical and imaging findings have some specific features and combined imaging examinations are necessary.

关 键 词：子宫平滑肌瘤 经静脉 右侧心腔 诊断 病经 征象 DSA检查 延伸 例子 MR 

分 类 号：R737.33[医药卫生—肿瘤] R732.22[医药卫生—临床医学]