多排螺旋CT诊断静脉内平滑肌瘤病的临床应用  

Clinical application of multi-detector row CT in the diagnosis of intravenous leiomyomatosis

作　　者：陈鑫[1] 张雪莲[1] 马小静[1] 彭志远[1] 陶园[1] 陈险峰[1] 胡文娟[1] 

机构地区：[1]武汉亚洲心脏病医院放射科,武汉430022

出　　处：《放射学实践》2013年第7期784-787,共4页Radiologic Practice

摘　　要：目的:探讨静脉内平滑肌瘤病的临床表现及MDCT特点,提高对此疾病的影像诊断水平。方法:搜集9例经手术病理证实静脉内平滑肌瘤病患者的临床及MDCT检查资料,回顾性分析其术前MDCT表现。结果:9例患者均于术前结合临床病史及MDCT表现做出准确诊断。9例患者均有子宫肌瘤病史,其中3例发现静脉内平滑肌瘤病前已行子宫切除术。9例CT均发现盆腔静脉及下腔静脉内低密度充盈缺损,2例下腔静脉低密度充盈缺损内可见钙化影,8例右心腔内见低密度充盈缺损,1例突入肺动脉内;病灶均呈中等不均匀强化。所有病变均与子宫平滑肌瘤原发灶或复发灶相延续。结论:MDCT不仅可以检出盆腔内原发子宫肌瘤病,同时可以明确腔静脉-右心-肺动脉受累范围,能对病变作出准确评估,为临床提供丰富的信息,对指导本病的临床治疗及评价预后有重要意义。Objective：To explore the clinical and multi-detector row spiral CT characteristics of intravenous invasion leiomyomatosis. Methods： The clinical materials of 9 cases with pathologically proven intravenous leiomyomatosis were col-lected,and the MDCT characteristics before surgery were retrospectively studied. Results： All of the 9 patients were accu- rately diagnosed before surgery according to the clinical materials in combination with MDCT manifestations. All had histo-ry of uterine leiomyoma,three had hysterectomy before the detection of intravenous leiomyomatosis. In 9 cases low density filling defect in pelvic vein and inferior vema cava were observed,and calcification was seen with in the filling defect in IVC in two cases. Filling defect in right cardiace chamber could be assessed in 8 cases,with extending of filling defect into the pulmonary artery in one case,all lesions showed moderate in homogenous enhancement. All the venous lesions were in con-tinccity with the primary or recurrent uterine leiomyoma. Conclusion： MDCT can not only detect the leiomyomatosis in ute-rus and pelvic veins, but also the intravenous leiomyomatosis involving the vena cava, right heart and pulmonary artery, which is helpful in the accurate evaluation of pathological changes, provide comprehensive clinical information,guidance of clinical treatment and prognosis prediction.

关 键 词：体层摄影术 X线计算机 静脉病变 子宫 平滑肌瘤病 下腔静脉 

分 类 号：R732.2[医药卫生—肿瘤]