子宫静脉内平滑肌瘤52例临床和病理特点及超声结果分析  

Clinical data,pathological characteristics and ultrasound results analysis in 52cases of uterine intravenous leiomyoma

作　　者：胡雁来[1] 朱勤[2] 赵蔚[1] 任芸芸[1] 

机构地区：[1]复旦大学附属妇产科医院超声科,上海200011 [2]复旦大学附属妇产科医院病理科,上海200011

出　　处：《复旦学报（医学版）》2013年第6期733-737,共5页Fudan University Journal of Medical Sciences

摘　　要：目的探讨子宫静脉内平滑肌瘤的临床、病理特点及超声声像图表现,提高对该病的超声检出率。方法回顾性分析我院2007年6月至2012年6月手术并病理证实的52例子宫静脉内平滑肌瘤的临床、病理特点及其超声检查结果。结果临床表现与普通子宫肌瘤相似,主诉为盆腹腔包块25例(48.1%);月经改变16例(30.8%);下腹坠胀感或疼痛9例(17.3%);白带增多2例(3.8%)。术前超声正确诊断3例(5.8%);误诊为子宫肌瘤29例(55.8%);子宫肌瘤伴变性11例(21.1%);子宫肌瘤伴肌腺症5例(9.6%),子宫肌腺症3例(5.8%),卵巢肿瘤1例(1.9%)。23例(44.2%)行全子宫及双侧附件切除术;3例(5.8%)行全子宫及一侧附件切除术;20例(38.5%)行全子宫切除术;6例(11.5%)行肌瘤剥除术。其中3例肌瘤剥除术患者因再次出现子宫增大,行全子宫切除术。结论子宫静脉内平滑肌瘤缺乏特异性声像图,是影响超声检查准确率的主要因素。Objective To study clinical data,pathological characteristics and ultrasonography imaging feature of uterine intravenous leiomyoma, so as to improve the detection rate of the disease. Methods We analysed clinical symptoms and ultrasonographic findings in 52 cases of uterine intravenous leiomyoma retrospectively,which had been treated and diagnosed by surgical pathology in our hospital from Jun., 2007 to Jun. , 2012. Results Clinical manifestations are similar to ordinary uterine fibroids. Twenty-five patients complained of pelvic mass （48. 1%）, 16 of them had changed menstruation （30.8%）,9 of them presented abdominal bulge or pain （17.3%） and 2 of them had increased leucorrhea （3.8%）. Before operation,only 3 cases were accurately diagnosed （5.8%） with ultrasonography. The cases of misdiagnosis by ultrasonography included 29 cases of uterine leiomyoma （55.8%）, 11 cases of uterine leiomyoma with degeneration （21. 1%）,5 cases of uterine leiomyoma with adenomyosis （9.6%）,3 cases of adenomyosis （5.8%） and 1 case of ovarian tumor （1.9%）. A total abdominal hysterectomy with bilateral/unilateral oophorectomy were performed in 26 cases. Only6 patients underwent uterine leiomyoma stripping surgery. Three of them underwent hysterectomy due to recurence of uterus increase with total hysterectomy. Conclusions I.acking of specific sonographic feature is the main factor that affecting the accuracy of ultrasound of uterine intravenous leiomyoma.

关 键 词：子宫 静脉内平滑肌瘤 超声检查 病理学 

分 类 号：R737.33[医药卫生—肿瘤]