病灶局限在盆腔脉管内平滑肌瘤MRI特征  

作　　者：夏星璐 李娟清[2] 孙进[2] 林俊[2] 

机构地区：[1]温州医科大学附属衢州医院(衢州市人民医院),324000 [2]浙江大学医学院附属妇产科医院,310006

出　　处：《浙江临床医学》2022年第5期750-752,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨病灶局限在盆腔脉管内平滑肌瘤病(IVL)MRI增强影像学特征性表现.方法 回顾性分析2014年9月至2021年9月术前行盆腔磁共振增强扫描且经术后病理证实为IVL 46例患者的临床资料,分析术前增强MRI扫描结果、手术方式、术中所见及随访结果.结果 46例患者年龄(43.33±9.26)岁,术后随访时间2~83个月,无失访人员,复发率4.35%.术前MRI影像学特征中有8例可见囊性成分,12例显示边界欠清,11例可见粗大血管,在MRI常规表现中T_(1)WI低信号及等信号41例(89.13%),T_(2)WI高信号18例(39.13%),增强强化显示不均匀强化32例(69.57%).结论 IVL是临床上少见的良性疾病,对于局限在盆腔内的I期患者,MRI诊断IVL时需关注其特征性表现,提高术前诊断准确性,术中仔细探查,小心处理,尽可能切除并切净病灶,降低复发率.Objective To investigate the MRI enhanced imaging characteristics of intravascular leiomyomatosis(IVL).Methods A retrospective analysis was performed on 46 patients admitted to Women's Hospital School of Medicine Zhejiang University from September 2014 to September 2021 who underwent preoperative pelvic enhanced magnetic resonance scan and were pathologically confirmed to have IVL after surgery.Clinical data,preoperative enhanced MRI scan results,surgical methods,intraoperative observations and follow-up results were collected and analyzed.Results The mean age of the 46 patients was(43.33±9.26)years old,and the follow-up time was from 2 months to 83 months after IVL.There was no lost to follow-up,and the recurrence rate was 4.35%.MRI scans showed that there were 8 cases of cystic components in preoperative MRI imaging features,12 cases showed unclear boundaries,and 11 cases showed large blood vessels.In conventional MRI findings,41 cases(89.13%)had low signal and equal signal on TiWI.There were 18 cases(39.13%)with high signal intensity on T_(2)WI,and 32 cases(69.57%)with uneven enhancement.Conclusions IVL is a rare benign disease in clinic.For stage I patients confined to the pelvic cavity,MRI diagnosis of IVL should pay attention toits characteristic manifestations,improve the accuracy of preoperative diagnosis,caretiil exploration and treatment during the operation,and remove and clean the lesion as far as possible to reduce the recurrence rate.

关 键 词：脉管内平滑肌瘤病 子宫肌瘤 MRI 复发率 

分 类 号：R73[医药卫生—肿瘤]